| Doctor Name: | CHONNA LYNN KENDRICK |
| NPI Number: | 1124344957 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 48475 |
| Business Practice Address: | 3851 Roger Brooke Drive Bamc, Mche-qd (creds) Fort Sam Houston, TX - 782346200 |
| Business Phone Number: | 2109164137 |
| Business Fax Number: | |
| Mailing Address: | 7601 Gateway Blvd Apt 337, LIVE OAK |
| State: | TX |
| Postal Code: | 782332678 |
| Phone Number: | 5016800262 |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2010 |
| NPI Last Update Date: | 05/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 48475 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |