Provider Demographics
NPI:1467892042
Name:ELWOOD, KENDRA L (MD)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:L
Last Name:ELWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:L
Other - Last Name:FRUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2710 SAINT FRANCIS DR STE 510
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5620
Mailing Address - Country:US
Mailing Address - Phone:319-272-5000
Mailing Address - Fax:
Practice Address - Street 1:2710 SAINT FRANCIS DR STE 510
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5620
Practice Address - Country:US
Practice Address - Phone:319-272-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IAMD-44368208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program