Healthcare Provider Details

I. General information

NPI: 1316773575
Provider Name (Legal Business Name): KENDALL CALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W PRESCOTT ST UNIT 3203
TAMPA FL
33616-2955
US

IV. Provider business mailing address

4950 W PRESCOTT ST UNIT 3203
TAMPA FL
33616-2955
US

V. Phone/Fax

Practice location:
  • Phone: 971-409-8026
  • Fax:
Mailing address:
  • Phone: 971-409-8026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9606699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: