Provider Demographics
NPI:1235857897
Name:FLEER, KENDALL ELLEN
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:ELLEN
Last Name:FLEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 W ALAMEDA AVE APT 412
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-2185
Mailing Address - Country:US
Mailing Address - Phone:303-877-2491
Mailing Address - Fax:
Practice Address - Street 1:20051 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-3135
Practice Address - Country:US
Practice Address - Phone:720-878-0919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist