Healthcare Provider Details

I. General information

NPI: 1588968978
Provider Name (Legal Business Name): MEREDITH A KENDELL-DUNLOW R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 FAIRWAY STREET SUITE 103
BOWLING GREEN KY
42103-2452
US

IV. Provider business mailing address

225 WEST CANTON AVENUE SUITE 600
WINTER PARK FL
32789-3181
US

V. Phone/Fax

Practice location:
  • Phone: 208-292-2188
  • Fax: 208-292-2189
Mailing address:
  • Phone: 407-347-4536
  • Fax: 812-285-8392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4004555
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: