Provider Demographics
NPI:1689338873
Name:KENDRA, ASHLEY (FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KENDRA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SCARAMUZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:485 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9369
Mailing Address - Country:US
Mailing Address - Phone:856-557-5555
Mailing Address - Fax:
Practice Address - Street 1:485 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9369
Practice Address - Country:US
Practice Address - Phone:856-557-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01211100207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty