Healthcare Provider Details

I. General information

NPI: 1063921856
Provider Name (Legal Business Name): KENDRA S MAGNER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

640 S STATE ST MAIL CODE 3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4700
  • Fax: 302-735-3246
Mailing address:
  • Phone: 302-674-4700
  • Fax: 302-735-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR119356
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberLK-0010275
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: