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General NPI Number Information
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NPI Number | 1134043847
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Entity Type | Organization
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Legal Business Name | KENCARE CLINIC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 813 LINDSEY PL
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City | LAKE WALES
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State | FL
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Zip | 33853-3576
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Country | US
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Telephone | 863-348-0997
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Fax | 863-474-0777
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Provider Business Mailing Address
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Address Line | 813 LINDSEY PL
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City | LAKE WALES
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State | FL
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Zip | 33853-3576
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Country | US
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Telephone | 863-348-0997
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Fax | 863-474-0777
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Authorized Official
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Title or Position | OWNER
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Name | FELICIA THOMAS
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Credential | APRN
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Telephone | 863-348-0997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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