Provider Demographics
NPI:1831595552
Name:KENNEDY MEAIRS, TERRA (CNM)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:KENNEDY MEAIRS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:TERRA
Other - Middle Name:
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:3312 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1910
Mailing Address - Country:US
Mailing Address - Phone:970-231-8589
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4597
Practice Address - Country:US
Practice Address - Phone:303-436-4949
Practice Address - Fax:303-602-9150
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991474-CNM367A00000X
CORXN.0101565-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE