Individual
KEVIN KOLLENKARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2755 HERNDON AVE, CLOVIS, CA 93611-6800
(559) 324-4000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3684
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA3684
CA
Other
Enumeration date
04/15/2008
Last updated
12/01/2021
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