Provider Demographics
NPI:1518648252
Name:SECREST, KENDRA R (SRNA)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:R
Last Name:SECREST
Suffix:
Gender:F
Credentials:SRNA
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Mailing Address - Street 1:PO BOX 840862
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0862
Mailing Address - Country:US
Mailing Address - Phone:303-377-7638
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:8000 E MAPLEWOOD AVE STE 120
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4766
Practice Address - Country:US
Practice Address - Phone:303-438-3999
Practice Address - Fax:720-439-9500
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2025-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLRN94783682086S0102X
COC-APN.0104445-C-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care