Provider Demographics
NPI:1821346081
Name:KENDRICK, DEBRA ANNETTE (RN, CCRN, CPAN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNETTE
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:RN, CCRN, CPAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13244 COUNTRY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1146
Mailing Address - Country:US
Mailing Address - Phone:301-801-1455
Mailing Address - Fax:
Practice Address - Street 1:WRNMMC B
Practice Address - Street 2:8901 WISCONSIN AVE, PACU
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN137104163W00000X
MDR163198163W00000X
FLRN9286349163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse