Provider Demographics
NPI:1326874405
Name:VONDUHN, KEITA (BSN, CCM)
Entity type:Individual
Prefix:
First Name:KEITA
Middle Name:
Last Name:VONDUHN
Suffix:
Gender:F
Credentials:BSN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 W RICE AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2014
Mailing Address - Country:US
Mailing Address - Phone:303-810-9594
Mailing Address - Fax:
Practice Address - Street 1:9802 W RICE AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2014
Practice Address - Country:US
Practice Address - Phone:303-810-9594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1622139163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management