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General NPI Number Information
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NPI Number | 1740645019
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Entity Type | Individual
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Provider Name | KENDRA LAURUHN
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Gender | Female
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 1930 E 20TH PL STE 400
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-2708
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Country | US
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Telephone | 308-633-2866
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Fax | 308-633-2874
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Provider Business Mailing Address
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Address Line | 1930 E 20TH PL STE 400
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-2708
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Country | US
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Telephone | 308-633-2866
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Fax | 308-633-2874
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2593
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 120
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License Number State | NE
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