Healthcare Provider Details

I. General information

NPI: 1831053560
Provider Name (Legal Business Name): KENDAL MCKENZIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 PLUMTREE RD STE B
BEL AIR MD
21015-6056
US

IV. Provider business mailing address

3216 LANHAM DR
ABINGDON MD
21009-3036
US

V. Phone/Fax

Practice location:
  • Phone: 410-638-1999
  • Fax:
Mailing address:
  • Phone: 410-375-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAG06250080
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: