Provider Demographics
NPI:1154080224
Name:ELCHERT, KENDRA (APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:ELCHERT
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 N TOWNSHIP ROAD 111
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-9353
Mailing Address - Country:US
Mailing Address - Phone:567-207-7916
Mailing Address - Fax:
Practice Address - Street 1:655 FOX RUN RD STE C
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8401
Practice Address - Country:US
Practice Address - Phone:567-525-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
OHAPRN.CNP.0030492363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty