Individual
PATTY JEAN KANDIKO
Active
Individual
PATTY JEAN KANDIKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
0990542
CO
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330749YXN7
MEDICARE ID
CO
05
—
62975862
—
CO
Enumeration date
12/03/2012
Last updated
08/22/2019
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