NPI | 1104242601 |
---|---|
Former Name | KENDRA AISHA RODGERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: LA 09276) |
Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: LA 155587) |
163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: NY 671713-1) | |
363LW0102X Nurse Practitioner, Women's Health (Licence: NY 421168) | |
Enumeration Date | 2014-03-09 |
Last Update Date | 2019-11-22 |