Provider Demographics
NPI:1134005754
Name:HERRIAGE, KENDRA RENEE MARIE
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:RENEE MARIE
Last Name:HERRIAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:RENEE MARIE
Other - Last Name:ARTUSSEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4101 NW EXPRESSWAY APT 16030
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1614
Mailing Address - Country:US
Mailing Address - Phone:405-450-2616
Mailing Address - Fax:
Practice Address - Street 1:4101 NW EXPRESSWAY APT 16030
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1614
Practice Address - Country:US
Practice Address - Phone:405-450-2616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator