Provider Demographics
NPI:1467206813
Name:WOODARD, KENDRA SHARDEA
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:SHARDEA
Last Name:WOODARD
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 1:2024 NAZARETH RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1231
Mailing Address - Country:US
Mailing Address - Phone:269-377-5182
Mailing Address - Fax:
Practice Address - Street 1:2024 NAZARETH RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1231
Practice Address - Country:US
Practice Address - Phone:269-377-5182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide