Individual
KENDRA MARIE STORER
Active
Individual
KENDRA MARIE STORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28176736A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71004511A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01307627
MEDICARE RR PTAN
IN
Enumeration date
05/30/2013
Last updated
06/14/2021
Update your record
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