Individual
LI'TOIA C KENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-8321
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
09000219A
IN
367A00000X
Advanced Practice Midwife
Primary
09000219A
IN
367A00000X
Advanced Practice Midwife
71004209A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09000219A
STATE LICENSE
IN
05
—
201118390
—
IN
01
—
264430H02
MEDICARE PTAN
IN
01
—
28168754A
STATE LICENSE
IN
Enumeration date
09/13/2012
Last updated
12/04/2023
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