Provider Demographics
NPI:1881051803
Name:KENNARD, JOAN (DNM, BD, CBP, CAT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:KENNARD
Suffix:
Gender:F
Credentials:DNM, BD, CBP, CAT
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:KENNARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2323 S TROY ST
Mailing Address - Street 2:STE 3-108
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1946
Mailing Address - Country:US
Mailing Address - Phone:303-683-5090
Mailing Address - Fax:
Practice Address - Street 1:2323 S TROY ST
Practice Address - Street 2:STE 3-108
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1946
Practice Address - Country:US
Practice Address - Phone:303-683-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist