Provider Demographics
NPI:1801217930
Name:TEMPLE, KENDAL (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:KENDAL
Middle Name:
Last Name:TEMPLE
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 1:113 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-4723
Mailing Address - Country:US
Mailing Address - Phone:781-489-5840
Mailing Address - Fax:
Practice Address - Street 1:113 OAK ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-4723
Practice Address - Country:US
Practice Address - Phone:781-489-5840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN228187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse