Individual
KIMBERLY DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
253 S LA GRANGE CIR, PUEBLO WEST, CO 81007-3169
(719) 369-6617
Mailing address
253 S LA GRANGE CIR, PUEBLO WEST, CO 81007-3169
(719) 369-6617
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.1634006
CO
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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