Healthcare Provider Details

I. General information

NPI: 1396529525
Provider Name (Legal Business Name): KENDRA MICHELLE HESS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S JACKSON ST
LOUISVILLE KY
40202-3229
US

IV. Provider business mailing address

529 S JACKSON ST
LOUISVILLE KY
40202-3229
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-7220
  • Fax: 502-588-8775
Mailing address:
  • Phone: 502-561-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4028074
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1146130
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: