# STACY H. KENDRICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821064395
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 004549 | GA | Yes |

## Other

- **Enumeration date:** 02/24/2006
- **Last updated:** 02/05/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 407818938A | — | GA |
| 05 | — | 407818938C | — | GA |
| 05 | — | 407818938D | — | GA |