Provider Demographics
NPI:1932872215
Name:KENDRICK, JESSICA TRUELOVE (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:TRUELOVE
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 BAHAMA RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-9543
Mailing Address - Country:US
Mailing Address - Phone:859-299-5002
Mailing Address - Fax:
Practice Address - Street 1:2179 BAHAMA RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-9543
Practice Address - Country:US
Practice Address - Phone:859-299-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant