Mariah Sage Kennell, DNP-FNP
Individual provider Active NPI Family Nurse Practitioner · Evans, CO
NPI 1649005661 · NPPES record last updated Jul 11, 2026
Key facts
- NPI
- 1649005661
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F06262053 (CO)
- Practice address
- 2930 11TH Ave
Evans, CO 80620-1011 - Phone
- (970) 353-9403
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65220 | NM | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F06262053 | CO | Yes |
| Registered Nurse | 163W00000X | RN.1674236 | CO |
Addresses
Primary practice location
2930 11TH Ave
Evans, CO 80620-1011
Mailing address
2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403
Other names
- Mariah Sage Kennell Mendoza
Other providers in Evans, CO
- Joshua Woodland
- Christopher Anne Kaleta
- Jessica Kanney
- Kenneth Harris Kaplan
- William Keckler
- Barnaby Kirshner
- Miranda Kortenhoeven
- Destinie S Loma
- Leonard Alexander Lowe Jr.
- Donald Lynch
All providers in Evans, CO · Family Nurse Practitioner in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.