Provider Demographics
NPI:1134811003
Name:BAKER, KENDELLA DOREEN
Entity type:Individual
Prefix:MRS
First Name:KENDELLA
Middle Name:DOREEN
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 N 56TH AVE APT 403
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1686
Mailing Address - Country:US
Mailing Address - Phone:954-399-0467
Mailing Address - Fax:
Practice Address - Street 1:3950 N 56TH AVE APT 403
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1686
Practice Address - Country:US
Practice Address - Phone:954-399-0467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula