Provider Demographics
NPI:1366894289
Name:MCNIVEN, KENEEN HOPE (DC)
Entity type:Individual
Prefix:
First Name:KENEEN
Middle Name:HOPE
Last Name:MCNIVEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 E 3RD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5255
Mailing Address - Country:US
Mailing Address - Phone:970-305-3239
Mailing Address - Fax:
Practice Address - Street 1:1309 E 3RD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5255
Practice Address - Country:US
Practice Address - Phone:970-305-3239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26-2939324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor