Healthcare Provider Details

I. General information

NPI: 1265833743
Provider Name (Legal Business Name): BRANDEY LEE KENDALL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 BUTNER DR
HOPE IN
47246-9447
US

IV. Provider business mailing address

11 TRAFALGAR SQ
TRAFALGAR IN
46181-9515
US

V. Phone/Fax

Practice location:
  • Phone: 812-546-6000
  • Fax: 812-546-0368
Mailing address:
  • Phone: 317-680-9103
  • Fax: 317-878-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28169899A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005179A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: