| NPI | 1649005661 |
|---|---|
| Former Name | MARIAH SAGE KENNELL MENDOZA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO F06262053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1674236) |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2026-07-11 |