Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | DR55363 | CO |
N | 208200000X | Surgeon | 200813978 | MO |
N | 208600000X | Surgeon | 200813978 | MO |
NPI | 1316168156 |
---|---|
Provider Name | Dr. Kendra Diane Conzen |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 01/10/2015 |