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General NPI Number Information
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NPI Number | 1235709668
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Entity Type | Individual
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Provider Name | KENDRA LUCINDA HOMER RN
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Gender | Female
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 525 N WOLFE ST
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City | BALTIMORE
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State | MD
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Zip | 21205-2110
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Country | US
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Telephone | 410-955-4766
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Fax |
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Provider Business Mailing Address
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Address Line | 618 S PORT ST
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City | BALTIMORE
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State | MD
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Zip | 21224-3647
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Country | US
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Telephone | 760-713-7126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | R247683
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License Number State | MD
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