BRENDA KISSICK (NPI# 1104396944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104396944 |
| Entity Type | Individual |
| Full Name | BRENDA KISSICK |
| Practice Address |
41 Montebello Rd Ste Ll1 Pueblo CO 81001-1379 |
| Mailing Address |
41 Montebello Rd Ste 202 Pueblo CO 81001-1366 |
| Practice Telephone | 7195452746 |
| Practice Fax Number | 7195429638 |
| Mailing Telephone | 7195452746 |
| Mailing Fax Number | 7195429638 |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2018-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | Other Service Providers |
| Street Address |
41 MONTEBELLO RD STE LL1 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-1379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750423703 | Emma Segura | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001 | 2007-02-13 |
| 1396343620 | Amber Van Acker | Registered Nurse | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2020-10-09 |
| 1598327058 | Erika Mcgough | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2019-07-05 |
| 1225500994 | Megan Chandler | Psychologist | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2018-12-19 |
| 1538639471 | Katherine Johnson | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2018-12-04 |
| 1912477753 | Yvonne Serna | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2018-12-04 |
| 1598230682 | Kendra Prater | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2018-10-04 |
| 1609358522 | Michael Ometer | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2018-09-06 |
| 1649772831 | Sara Ackerman | Registered Nurse | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2018-03-02 |
| 1770005852 | Mary Helen Davies | Counselor | 41 Montebello Rd Ste Ll1, Pueblo, CO 81001-1379 | 2017-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
| Find all providers in zip 81001 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346792611 | Stephanie Solano | Driver | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2016-11-02 |
| 1699172577 | John Carrero | Driver | 41 Montebello Rd, Suite 100, Pueblo, CO 81001-1379 | 2014-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871047 | Kidist Alemayehu | Driver | 8861 E Florida Ave Apt B218, Denver, CO 80247-2836 | 2020-11-03 |
| 1003414988 | Addisu Alemu Birega I | Driver | 600 S Dayton St Apt 3-203, Denver, CO 80247-1330 | 2020-10-13 |
| 1003425349 | Selamawit Teradaw Wolde | Driver | 1633 E Woodmen Rd Apt 20, Colorado Springs, CO 80920-3301 | 2020-07-22 |
| 1528685765 | Leilety Getahun Tsehaye | Driver | 10062 E Wyoming Pl, Apartment #2217, Aurora, CO 80247-6380 | 2020-07-04 |
| 1013531904 | Nathnael Andemaryam | Driver | 7945 E Colfax Ave, Denver, CO 80220-2032 | 2020-06-05 |
| 1801410899 | Lawrence Kofi Frimpong | Driver | 2042 Babbling Stream Hts, Colorado Springs, CO 80910-3015 | 2020-06-04 |
| 1033756283 | South West Medical Transport | Driver | 246 Echo Creek Dr, Pagosa Springs, CO 81147-0047 | 2019-12-06 |
| 1114562022 | Laprell Boston | Driver | 5515 Trout Creek Pass Dr, Colorado Springs, CO 80917-2741 | 2019-11-14 |
| 1760038905 | Zaid Yemane Gessese | Driver | 8841 E Florida Ave Apt A108, Denver, CO 80247-2882 | 2019-08-14 |
| 1407408495 | Peace of Mind Medical Rides | Driver | 9653 Beryl Dr, Peyton, CO 80831-4445 | 2019-07-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.