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General NPI Number Information
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NPI Number | 1275515629
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Entity Type | Individual
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Provider Name | YANA KENNEDY APN
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 8410 DECATUR ST STE 100
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City | WESTMINSTER
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State | CO
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Zip | 80031-3811
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Country | US
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Telephone | 303-430-7000
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Fax | 303-430-1506
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Provider Business Mailing Address
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Address Line | 4891 INDEPENDENCE ST STE 120
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-6713
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Country | US
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Telephone | 303-456-5495
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Fax | 303-456-7490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0004618-CNS
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License Number State | CO
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