Provider Demographics
NPI:1538617949
Name:BALSIGER, KENDRA (PA-C)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:BALSIGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:GERK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:919 JASMINE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4588
Mailing Address - Country:US
Mailing Address - Phone:303-388-4256
Mailing Address - Fax:303-388-7802
Practice Address - Street 1:919 JASMINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4588
Practice Address - Country:US
Practice Address - Phone:303-388-4256
Practice Address - Fax:303-388-7802
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4712363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant