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General NPI Number Information
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NPI Number | 1528262797
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Entity Type | Individual
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Provider Name | KENDRA NALLS CNA
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 05/19/2024
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Provider Practice Location Address
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Address Line | 734 GREEN RIDGE DR W APT L
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City | BROWNSBURG
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State | IN
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Zip | 46112-2463
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Country | US
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Telephone | 317-677-3314
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Fax |
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Provider Business Mailing Address
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Address Line | 734 GREEN RIDGE DR W APT L
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City | BROWNSBURG
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State | IN
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Zip | 46112-2463
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Country | US
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Telephone | 317-677-3314
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 48-01-04-01734
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License Number State | IN
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