Healthcare Provider Details

I. General information

NPI: 1063326825
Provider Name (Legal Business Name): KENDRA LEMON-JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5326 N 63RD ST
MILWAUKEE WI
53218-3115
US

IV. Provider business mailing address

9700 W CAPITOL DR APT 2
MILWAUKEE WI
53222-1468
US

V. Phone/Fax

Practice location:
  • Phone: 414-397-0743
  • Fax:
Mailing address:
  • Phone: 414-397-0743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number0021730
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: