Provider Demographics
NPI:1417371543
Name:MULHOLLAND, KENDRA R
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:R
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-967-6400
Mailing Address - Fax:954-337-5755
Practice Address - Street 1:7215 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1051
Practice Address - Country:US
Practice Address - Phone:863-452-1818
Practice Address - Fax:419-996-5458
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA15548363LA2100X
OHNP15548363LP2300X
FLAPRN11028828363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care