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Individual

JAKE E KENDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APNP

Contact information

Practice address
2500 E CAPITOL DR, APPLETON, WI 54911-8735
(920) 830-6788
(999) 999-9999
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5970

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19857
TN
363LF0000X
Family Nurse Practitioner
Primary
7899
WI

Other

Enumeration date
09/18/2015
Last updated
07/21/2022
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