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Individual

MS. WENDY L KENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2551 W 84TH AVE, WESTMINSTER, CO 80031-3807
(720) 255-2953
Mailing address
PO BOX 1802, BERTHOUD, CO 80513-1802
(720) 255-2953

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2199
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42121540
CO
01
527213
UPIN
CO
Enumeration date
08/11/2006
Last updated
04/14/2015
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