Provider Demographics
NPI:1710745633
Name:LOWE, KENDRA KAY (LPN)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:KAY
Last Name:LOWE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:KAY
Other - Last Name:FONTANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:3028 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-1949
Mailing Address - Country:US
Mailing Address - Phone:727-271-8860
Mailing Address - Fax:
Practice Address - Street 1:900 VIRGINIA ST E STE 400
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2835
Practice Address - Country:US
Practice Address - Phone:681-313-4759
Practice Address - Fax:844-800-3954
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5215688164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse