Healthcare Provider Details

I. General information

NPI: 1811210784
Provider Name (Legal Business Name): KENDRA R ADAMS C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 WATERS AVE
SAVANNAH GA
31404-6220
US

IV. Provider business mailing address

4700 WATERS AVE
SAVANNAH GA
31404-6220
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-8758
  • Fax: 912-350-6509
Mailing address:
  • Phone: 912-350-8758
  • Fax: 912-350-6509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9264626
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number175980
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: