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NPI Code Detail

MEDICARE: HOLLY J KENDRICK NP

MEDICARE: HOLLY J KENDRICK NP
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
1363L00000XNurse PractitionerR887672MS

General Provider Information

NPI Number : 1871892570
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY J KENDRICK NP
Provider Business Mailing Address
First Line : PO BOX 11407
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35246-1218
Country : US
Telephone Number : 800-897-6169
Fax Number : 800-897-6170
Provider Business Practice Location Address
First Line : 2089 SOUTHRIDGE DR
Second Line :
City : TUPELO
State : MS
Zip : 38801-6478
Country : US
Telephone Number : 662-407-0801
Fax Number : 662-407-0807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2011
Last Update Date : 10/16/2012

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Directions to “ HOLLY J KENDRICK NP” Practice Location

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