Provider Demographics
NPI:1083456651
Name:POLIZZO, KENDRA (FNP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:POLIZZO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:TX
Mailing Address - Zip Code:76250-0089
Mailing Address - Country:US
Mailing Address - Phone:940-736-3630
Mailing Address - Fax:
Practice Address - Street 1:424 CHURCH ST STE 2600
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219-2379
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179187363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty