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NPI Code Detail

MEDICARE: LAWANDA JOI KENDALL

MEDICARE: LAWANDA JOI KENDALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11406316054OTHERNVNV DRIVER LICENSE

General Provider Information

NPI Number : 1114597945
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWANDA JOI KENDALL
Provider Business Mailing Address
First Line : 3546 DROMEDARY WAY APT 2341
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-3022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3546 DROMEDARY WAY APT 2341
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-3022
Country : US
Telephone Number : 424-264-6964
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2021
Last Update Date : 06/24/2021

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Directions to “ LAWANDA JOI KENDALL ” Practice Location

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