Provider Demographics
NPI:1225412901
Name:KENDRICK, BROOKELYNN K (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BROOKELYNN
Middle Name:K
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 FLORIDA AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2484
Mailing Address - Country:US
Mailing Address - Phone:321-636-7780
Mailing Address - Fax:321-633-3043
Practice Address - Street 1:1286 FLORIDA AVE S
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2484
Practice Address - Country:US
Practice Address - Phone:321-636-7780
Practice Address - Fax:321-633-3043
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9314285363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner