Healthcare Provider Details

I. General information

NPI: 1285899138
Provider Name (Legal Business Name): KENDRA LEIGH ROLOFF ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDRA LEIGH KNODEL

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14355 MIRANDA WAY
LOS ALTOS HILLS CA
94022-2032
US

IV. Provider business mailing address

3100 N 11TH ST STE 1
BISMARCK ND
58503-1210
US

V. Phone/Fax

Practice location:
  • Phone: 701-989-5885
  • Fax:
Mailing address:
  • Phone: 701-751-2272
  • Fax: 701-751-0974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number296582
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1130981
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP9278854
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR33969
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: