Doctor Name: | MYRA E KENDALL |
NPI Number: | 1831160670 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | A01360 ANP |
Business Practice Address: | 301 S Main St Cave City, AR - 725219476 |
Business Phone Number: | 8702835353 |
Business Fax Number: | 8702835988 |
Mailing Address: | Po Box 247, CAVE CITY |
State: | AR |
Postal Code: | 725210247 |
Phone Number: | 8702835353 |
Fax Number: | 8702835988 |
NPI Enumeration Date: | 01/30/2006 |
NPI Last Update Date: | 11/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A01360 ANP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |