Individual ProviderKenneth L. CorderoRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix, AZ 85016-5319(602) 263-1200PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth L. Cordero does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1275951352Provider TypeIndividualFull NameCordero, Kenneth L.CredentialRNGenderMaleSole ProprietorNoEnumeration Date4/4/2014Last Updated8/24/2016Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix, AZ 85016-5319Phone(602) 263-1200Fax(602) 200-5383Mailing LocationMailing AddressPO Box 31001-0698, Pasadena, CA 91110-0698Phone(602) 263-1200Fax(602) 200-5383Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN 9431349FloridaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense9713Puerto Rico