MEDICARE: KENDRA POLIZZO DNP, APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1179187	TX

General Provider Information

NPI Number	:	1083456651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA POLIZZO DNP, APRN, FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 89
Second Line	:
City	:	LINDSAY
State	:	TX
Zip	:	76250-0089
Country	:	US
Telephone Number	:	940-736-3630
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N GRAND AVE
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-3573
Country	:	US
Telephone Number	:	940-665-4121
Fax Number	:	940-668-0833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	06/04/2026

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