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NPI Code Detail

MEDICARE: DR. KENDRA MARIE STUKE LSCSW

MEDICARE: DR. KENDRA MARIE STUKE LSCSW
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
11041C0700XClinical Social WorkerLSCSW 3860KS
21041C0700XClinical Social Worker3266KS

General Provider Information

NPI Number : 1265576805
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENDRA MARIE STUKE LSCSW
Provider Business Mailing Address
First Line : 720 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6355
Country : US
Telephone Number : 785-320-7331
Fax Number :
Provider Business Practice Location Address
First Line : 720 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6355
Country : US
Telephone Number : 785-320-7331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 06/27/2023

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