Provider Demographics
NPI:1366924763
Name:FOREMAN, KENDRA LASHON (APRN)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:LASHON
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1230 W 24TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6232
Mailing Address - Country:US
Mailing Address - Phone:928-314-3702
Mailing Address - Fax:928-314-4687
Practice Address - Street 1:1230 W 24TH ST
Practice Address - Street 2:STE 1
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6232
Practice Address - Country:US
Practice Address - Phone:928-314-3702
Practice Address - Fax:928-314-4687
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ226350363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3012282OtherKY BOARD OF NURSING
ARA005485OtherARKANSAS BOARD OF NURSING
AZ226350OtherARIZONA BOARD OF NURSING