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NPI Code Detail

MEDICARE: KENDRA R KAUFMAN PA-C

MEDICARE: KENDRA R KAUFMAN PA-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
1363AM0700XMedical Physician Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417139452
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA R KAUFMAN PA-C
Provider Business Mailing Address
First Line : 500 W RIVER DR
Second Line :
City : DAVENPORT
State : IA
Zip : 52801-1014
Country : US
Telephone Number : 563-336-3000
Fax Number : 563-336-3125
Provider Business Practice Location Address
First Line : 2750 11TH ST
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-5216
Country : US
Telephone Number : 563-327-2100
Fax Number : 563-327-2102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2007
Last Update Date : 04/18/2013

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Directions to “ KENDRA R KAUFMAN PA-C” Practice Location

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