Healthcare Provider Details

I. General information

NPI: 1609027168
Provider Name (Legal Business Name): KENDRA MARSH-KATES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KENDRA MARSH M.D.

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 S WEBSTER AVE
GREEN BAY WI
54301-2253
US

IV. Provider business mailing address

3430 CONCERTO LN
GREEN BAY WI
54311-7368
US

V. Phone/Fax

Practice location:
  • Phone: 920-429-1777
  • Fax:
Mailing address:
  • Phone: 920-634-6588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036115455
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number53352-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: