Provider Demographics
NPI:1558136358
Name:GIFFIN, KENDRA RENAE (CPM, RN)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:RENAE
Last Name:GIFFIN
Suffix:
Gender:F
Credentials:CPM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 HOLIDAY TER
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:KS
Mailing Address - Zip Code:66043-1254
Mailing Address - Country:US
Mailing Address - Phone:913-218-6374
Mailing Address - Fax:816-866-9251
Practice Address - Street 1:4444 N BELLEVIEW AVE STE 204
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1507
Practice Address - Country:US
Practice Address - Phone:816-659-2305
Practice Address - Fax:816-866-9251
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10090043176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife