MEDICARE: KENZIE L STAPLETON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1851241293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENZIE L STAPLETON

Provider Business Mailing Address
First Line	:	PO BOX 604
Second Line	:
City	:	RYE
State	:	CO
Zip	:	81069-0604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 CLUB MANOR DR
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81008-2004
Country	:	US
Telephone Number	:	719-696-7799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

Similar Medicare Providers

1033069489 — ALAINA MARIE ECKHARDT
Practice Location Address:

4025 CLUB MANOR DR
PUEBLO, CO
81008-2004

Practice Phone: 719-696-7799
Practice Fax:

1316058126 — CATHOLIC HEALTH INITIATIVES COLORADO
Practice Location Address:

4025 CLUB MANOR DR , SUITE 102
PUEBLO, CO
81008-2004

Practice Phone: 719-566-6600
Practice Fax: 719-566-6606

1881323889 — LPS LEGACY ENTERPRISES LLC
Practice Location Address:

4023 CLUB MANOR DR
PUEBLO, CO
81008-2004

Practice Phone: 719-671-2362
Practice Fax:

1073491429 — BUCK JACK, LLC
Practice Location Address:

4025 CLUB MANOR DR
PUEBLO, CO
81008-2004

Practice Phone: 719-597-0822
Practice Fax:

1982582334 — BUCK JACK, LLC
Practice Location Address:

4025 CLUB MANOR DR
PUEBLO, CO
81008-2004

Practice Phone: 719-597-0822
Practice Fax:

1356215859 — LILIANA MARIE ARAGON
Practice Location Address:

4025 CLUB MANOR DR
PUEBLO, CO
81008-2004

Practice Phone: 719-357-4066
Practice Fax:

Directions to “ KENZIE L STAPLETON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.