Provider Demographics
NPI:1083813190
Name:KENDRICK, CELESTE D (FNP)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:D
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2928 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-5426
Mailing Address - Country:US
Mailing Address - Phone:970-584-2100
Mailing Address - Fax:970-584-2101
Practice Address - Street 1:2928 W 10TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5426
Practice Address - Country:US
Practice Address - Phone:970-584-2100
Practice Address - Fax:970-584-2101
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO178633363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily