| Doctor Name: | ELIZABETH KENDALL |
| NPI Number: | 1679979660 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1-121810 |
| Business Practice Address: | 55 Boulder Dr Pike Road, AL - 360642868 |
| Business Phone Number: | 3342947909 |
| Business Fax Number: | |
| Mailing Address: | Po Box 241348, MONTGOMERY |
| State: | AL |
| Postal Code: | 361241348 |
| Phone Number: | 3342887808 |
| Fax Number: | 3343873090 |
| NPI Enumeration Date: | 11/18/2014 |
| NPI Last Update Date: | 09/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1-121810 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |