Provider Demographics
NPI:1033700885
Name:KENDRICK, MADISON (FNP)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:GUMPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237A STATE RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-2612
Mailing Address - Country:US
Mailing Address - Phone:508-979-1100
Mailing Address - Fax:
Practice Address - Street 1:237A STATE RD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2612
Practice Address - Country:US
Practice Address - Phone:508-979-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2308334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily