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General NPI Number Information
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NPI Number | 1295956621
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Entity Type | Individual
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Provider Name | KENDIS MOORE DRAKE RN,NP
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1008 E MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85006-2603
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Country | US
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Telephone | 602-393-0661
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Fax | 602-254-3474
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Provider Business Mailing Address
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Address Line | 4490 N DROMEDARY RD
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City | PHOENIX
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State | AZ
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Zip | 85018-2952
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Country | US
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Telephone | 602-952-9074
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Fax | 602-840-9685
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN038738
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License Number State | AZ
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