MEDICARE: MRS. PATRICIA JEAN KENDALL 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
1	363LF0000X	Family Nurse Practitioner	F334642-1	NY

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	:	1922131309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA JEAN KENDALL NP

Provider Business Mailing Address
First Line	:	629 MOSCOW RD # 278980
Second Line	:
City	:	HAMLIN
State	:	NY
Zip	:	14464-9729
Country	:	US
Telephone Number	:	585-797-8069
Fax Number	:	585-637-5626

Provider Business Practice Location Address
First Line	:	629 MOSCOW RD
Second Line	:
City	:	HAMLIN
State	:	NY
Zip	:	14464-9729
Country	:	US
Telephone Number	:	585-797-8069
Fax Number	:	201-547-1965

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	06/05/2023

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