Provider Demographics
NPI:1063838613
Name:IPPEL, KENDRA (LM, CPM)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:IPPEL
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3313
Mailing Address - Country:US
Mailing Address - Phone:773-578-2728
Mailing Address - Fax:407-656-9161
Practice Address - Street 1:213 S DILLARD ST
Practice Address - Street 2:SUITE 340
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3596
Practice Address - Country:US
Practice Address - Phone:407-656-6938
Practice Address - Fax:407-656-9161
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTMW7176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife