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General NPI Number Information
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NPI Number | 1407604747
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Entity Type | Individual
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Provider Name | KENDRA STROUD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2024
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 5801 SHELBY ST
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City | LOUISVILLE
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State | KY
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Zip | 40291-1352
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Country | US
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Telephone | 502-676-9842
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Fax |
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Provider Business Mailing Address
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Address Line | 6844 BARDSTOWN RD UNIT 2340
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City | LOUISVILLE
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State | KY
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Zip | 40291-3050
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Country | US
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Telephone | 502-654-5121
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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