Provider Demographics
NPI:1679724165
Name:KUIPHOFF, BRENDA ANNETTE (RN)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:ANNETTE
Last Name:KUIPHOFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14316 W WESLEY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-5420
Mailing Address - Country:US
Mailing Address - Phone:303-988-1448
Mailing Address - Fax:
Practice Address - Street 1:14316 W WESLEY CIR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-5420
Practice Address - Country:US
Practice Address - Phone:303-988-1448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO120637163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse