Provider Demographics
NPI:1922131309
Name:KENDALL, PATRICIA JEAN (NP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JEAN
Last Name:KENDALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 MOSCOW RD # 278980
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:NY
Mailing Address - Zip Code:14464-9729
Mailing Address - Country:US
Mailing Address - Phone:585-797-8069
Mailing Address - Fax:585-637-5626
Practice Address - Street 1:629 MOSCOW RD
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:NY
Practice Address - Zip Code:14464-9729
Practice Address - Country:US
Practice Address - Phone:585-797-8069
Practice Address - Fax:201-547-1965
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334642-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02938181Medicaid