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Individual

CHELSEA GLADYS KENDRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
106 SE 49TH DR, GAINESVILLE, FL 32641-1921
(352) 283-1638
Mailing address
PO BOX 5193, GAINESVILLE, FL 32627-5193
(352) 226-9496

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
FL
347C00000X
Private Vehicle
FL
372600000X
Adult Companion
Primary
FL
374U00000X
Home Health Aide
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12345678
FL
Enumeration date
04/14/2017
Last updated
08/16/2021
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