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NPI Code Detail

MEDICARE: KENDAL NOBLE APRN

MEDICARE: KENDAL NOBLE APRN
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
1363LF0000XFamily Nurse PractitionerA005939AR

General Provider Information

NPI Number : 1558831644
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDAL NOBLE APRN
Provider Business Mailing Address
First Line : PO BOX 509
Second Line :
City : DERMOTT
State : AR
Zip : 71638-0509
Country : US
Telephone Number : 870-538-5414
Fax Number :
Provider Business Practice Location Address
First Line : 110 N DREW ST
Second Line :
City : STAR CITY
State : AR
Zip : 71667-5704
Country : US
Telephone Number : 870-628-5110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2018
Last Update Date : 06/07/2021

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