Provider Demographics
NPI:1700426038
Name:KENDRICK, ASHLEY MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 ROSSVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-2250
Mailing Address - Country:US
Mailing Address - Phone:423-265-3122
Mailing Address - Fax:423-265-2932
Practice Address - Street 1:2347 ROSSVILLE BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-2250
Practice Address - Country:US
Practice Address - Phone:423-265-3122
Practice Address - Fax:423-265-2932
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN102320164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse