Provider Demographics
NPI:1457005985
Name:DENHAMS, KEONDUS
Entity Type:Individual
Prefix:
First Name:KEONDUS
Middle Name:
Last Name:DENHAMS
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 1:155 N LAKEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-5852
Mailing Address - Country:US
Mailing Address - Phone:225-241-2283
Mailing Address - Fax:
Practice Address - Street 1:155 N LAKEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-5852
Practice Address - Country:US
Practice Address - Phone:225-241-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)