Provider Demographics
NPI:1184498420
Name:KIDDER, RACHEL LAUREN (MLS(ASCP)CM)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LAUREN
Last Name:KIDDER
Suffix:
Gender:F
Credentials:MLS(ASCP)CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3682 S PERTH CIR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-7509
Mailing Address - Country:US
Mailing Address - Phone:574-312-4237
Mailing Address - Fax:
Practice Address - Street 1:3682 S PERTH CIR UNIT 104
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-7509
Practice Address - Country:US
Practice Address - Phone:574-312-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN264490246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist