Provider Demographics
NPI:1740329572
Name:KAPPEDAL, LAUREL (FNP)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:KAPPEDAL
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 1:13137 E 23RD AVE
Mailing Address - Street 2:5502 USAH
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7417
Mailing Address - Country:US
Mailing Address - Phone:303-365-3055
Mailing Address - Fax:
Practice Address - Street 1:13137 E 23RD AVE
Practice Address - Street 2:5502 USAH
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7417
Practice Address - Country:US
Practice Address - Phone:303-365-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200550011NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily