MEDICARE: KENDRA LAUREN KASPER

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1346192267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA LAUREN KASPER

Provider Business Mailing Address
First Line	:	73 WAVERLY ST APT 4
Second Line	:
City	:	ROXBURY
State	:	MA
Zip	:	02119-2189
Country	:	US
Telephone Number	:	920-691-6162
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 MILLER ST
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-4725
Country	:	US
Telephone Number	:	617-847-1914
Fax Number	:

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

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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