Healthcare Provider Details

I. General information

NPI: 1558277384
Provider Name (Legal Business Name): KENDRA MARIE MAYNARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 STANFORD RD
LANCASTER KY
40444-9547
US

IV. Provider business mailing address

516 SLEEPY HOLLOW RD
HARRODSBURG KY
40330-8795
US

V. Phone/Fax

Practice location:
  • Phone: 859-239-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4060403
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: