Healthcare Provider Details

I. General information

NPI: 1437638236
Provider Name (Legal Business Name): KENDRA E CLINE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDRA E GOUGH

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 WHITEHALL ROAD SUITE 301
ROCHESTER NH
03867
US

IV. Provider business mailing address

21 WHITEHALL ROAD SUITE 301
ROCHESTER NH
03867
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-6066
  • Fax:
Mailing address:
  • Phone: 603-692-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF343459
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: