Provider Demographics
NPI:1205476637
Name:DENHOLM, KENDRA (LM, CPM)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:DENHOLM
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3092 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-9712
Mailing Address - Country:US
Mailing Address - Phone:231-384-0679
Mailing Address - Fax:
Practice Address - Street 1:3092 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9712
Practice Address - Country:US
Practice Address - Phone:231-384-0679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7602000008176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife