Provider Demographics
NPI:1508256512
Name:KENDALL, NANCY LUONG (APRN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LUONG
Last Name:KENDALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 EAST WEST ROAD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822
Mailing Address - Country:US
Mailing Address - Phone:808-956-8965
Mailing Address - Fax:808-956-5834
Practice Address - Street 1:1710 EAST WEST ROAD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822
Practice Address - Country:US
Practice Address - Phone:808-956-8965
Practice Address - Fax:808-956-5834
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19490363LF0000X
HIAPRN-1851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily