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Individual

KENDRA A YODFAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
111 S FRONT STREET, HARRISBURG, PA 17101-2010
(717) 782-5182
(717) 782-8520
Mailing address
118 WASHINGTON STREET, HARRISBURG, PA 17104-1612

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN518902L
PA
367500000X
Certified Registered Nurse Anesthetist
071131
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN518902L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001595427
HIGHMARK BLUE SHIELD
PA
Enumeration date
10/03/2006
Last updated
10/20/2008
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