MEDICARE: CARA KENDRICK DNP, APRN, CPNP-PC

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	363LP0200X	Pediatric Nurse Practitioner	26334	SC

General Provider Information

NPI Number	:	1245966514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA KENDRICK DNP, APRN, CPNP-PC

Provider Business Mailing Address
First Line	:	4975 LACROSS RD STE 150
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-6531
Country	:	US
Telephone Number	:	843-696-3923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1952 LONG GROVE DR STE 202
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-7579
Country	:	US
Telephone Number	:	843-971-2992
Fax Number	:

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

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