MEDICARE: MRS. KENDRA NOELLE HEAD APRN

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
1	363LF0000X	Family Nurse Practitioner	19299	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437540911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KENDRA NOELLE HEAD APRN

Provider Business Mailing Address
First Line	:	SC HOUSE CALLS, INC.
Second Line	:	111 DOCTORS CIR.
City	:	COLUMBIA
State	:	SC
Zip	:	29203
Country	:	US
Telephone Number	:	800-491-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	SC HOUSE CALLS, INC.
Second Line	:	111 DOCTORS CIR.
City	:	COLUMBIA
State	:	SC
Zip	:	29203
Country	:	US
Telephone Number	:	800-491-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2015
Last Update Date	:	06/01/2026

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