Provider Demographics
NPI:1265395255
Name:EDWARDS, KENDRA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 ACADEMY CIR STE B
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1674
Mailing Address - Country:US
Mailing Address - Phone:719-581-6646
Mailing Address - Fax:
Practice Address - Street 1:2120 ACADEMY CIR STE B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1674
Practice Address - Country:US
Practice Address - Phone:719-581-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula