Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 21969 | OK |
Y | 207N00000X | Dermatologist | A98696 | CA |
NPI | 1033144183 |
---|---|
Provider Name | Christina G Kendrick |
First Address | Tulsa, OK 74114-1409 |
Second Address | Tulsa, OK 74114-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 13/08/2008 |