Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 02006534A | IN |
N | 207Q00000X | Family Doctor | OS7976 | FL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 02006534A | IN |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | OS7976 | FL |
N | 208D00000X | General Practice Physician | 0S7976 | FL |
NPI | 1164438859 |
---|---|
Provider Name | Dr. Kendra Sue Hall-Franks |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Lakeland, FL 33805-1946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01692A | (02) | FL |
264692700 | (05) | FL |
H43936 | (02) | |
H43936 | (02) | FL |