Provider Demographics
NPI:1144770694
Name:DUCKSTEIN, KENDRA (APNP)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:DUCKSTEIN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7702
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-0702
Mailing Address - Country:US
Mailing Address - Phone:970-663-2742
Mailing Address - Fax:970-342-2093
Practice Address - Street 1:19284 COTTONWOOD DR STE 204
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3881
Practice Address - Country:US
Practice Address - Phone:303-840-8346
Practice Address - Fax:719-542-7019
Is Sole Proprietor?:No
Enumeration Date:2016-10-08
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0169809163W00000X
CORN.169809163W00000X
CORXN.0102056-NP363LA2200X
CO0992399363LA2200X
COAPN.0992399-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse