MEDICARE: MRS. KENDRA S HENDON M.D.

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	207RN0300X	Nephrology Physician	01057279	IN
2	207RN0300X	Nephrology Physician	MD000036173	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1538169305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KENDRA S HENDON M.D.

Provider Business Mailing Address
First Line	:	320 N PARK 40 BLVD STE A
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3624
Country	:	US
Telephone Number	:	865-692-3462
Fax Number	:	865-692-3463

Provider Business Practice Location Address
First Line	:	320 PARK 40 NORTH BLVD
Second Line	:	SUITE A
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3624
Country	:	US
Telephone Number	:	865-692-3462
Fax Number	:	865-692-3463

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	02/16/2026

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Directions to “ MRS. KENDRA S HENDON M.D.” Practice Location

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