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General NPI Number Information
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NPI Number | 1649515685
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Entity Type | Individual
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Provider Name | PATTY JEAN KANDIKO CNM
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Gender | Female
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 2241 N 7TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7423
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Country | US
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Telephone | 970-549-1711
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Fax | 970-314-2633
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Provider Business Mailing Address
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Address Line | 2241 N 7TH ST
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7423
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Country | US
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Telephone | 970-549-1711
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Fax | 970-314-2633
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0990542
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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