Basic Information
| Provider Information | |||||||||
| NPI: | 1104217983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAGEY | ||||||||
| FirstName: | KENDRA | ||||||||
| MiddleName: | LUDWIG | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 FORBES ST | ||||||||
| Address2: | #200 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214011538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102636363 | ||||||||
| FaxNumber: | 4102637551 | ||||||||
| Practice Location | |||||||||
| Address1: | 195 W 14TH STE C | ||||||||
| Address2: | |||||||||
| City: | RIFLE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816504717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709452840 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2015 | ||||||||
| LastUpdateDate: | 06/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | R197297 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.