Individual
JACK NEIL KENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
488 KENNESAW AVE NW STE 100, MARIETTA, GA 30060-9409
(404) 888-7590
Mailing address
10 GLENLAKE PKWY STE 900, ATLANTA, GA 30328-7249
(404) 888-7590
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
APN.APRN18085
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN-CRNA123295
GA
367500000X
Certified Registered Nurse Anesthetist
RN192749
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2258
—
SC
Enumeration date
07/19/2006
Last updated
12/02/2025
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