Provider Demographics
NPI:1629789607
Name:FELICIANO, KENDRA MARLENE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MARLENE
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 RIVERDALE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-3706
Mailing Address - Country:US
Mailing Address - Phone:401-644-0359
Mailing Address - Fax:
Practice Address - Street 1:28 RIVERDALE AVE APT B
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-3706
Practice Address - Country:US
Practice Address - Phone:401-644-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN70251163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical