Provider Demographics
NPI:1316719040
Name:KOKORA, KENDALL (FNP-C)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:KOKORA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:RUBESHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3675 E CODY AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2927
Mailing Address - Country:US
Mailing Address - Phone:562-640-1789
Mailing Address - Fax:
Practice Address - Street 1:1425 S GREENFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5505
Practice Address - Country:US
Practice Address - Phone:480-964-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ299386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily