Healthcare Provider Details

I. General information

NPI: 1447633375
Provider Name (Legal Business Name): KENDRA MARCINOWSKI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 CENTERVILLE RD SUITE 202
TALLAHASSEE FL
32308-4647
US

IV. Provider business mailing address

1401 CENTERVILLE RD SUITE 202
TALLAHASSEE FL
32308-4647
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-7241
  • Fax: 850-877-1338
Mailing address:
  • Phone: 850-877-7241
  • Fax: 850-877-1338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP 3291382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: