Provider Demographics
NPI:1710242755
Name:FAUCETT, KENDRA (APRN,CNM)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:FAUCETT
Suffix:
Gender:F
Credentials:APRN,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BEAR TRAK
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2222
Mailing Address - Country:US
Mailing Address - Phone:859-327-6368
Mailing Address - Fax:
Practice Address - Street 1:113 BEAR TRAK
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2222
Practice Address - Country:US
Practice Address - Phone:859-327-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000034468367A00000X
KY3007509367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100215590Medicaid