Provider Demographics
NPI:1083184345
Name:HARRIS, KENDRA MONIQUE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:MONIQUE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4277
Mailing Address - Country:US
Mailing Address - Phone:972-792-7300
Mailing Address - Fax:972-792-7309
Practice Address - Street 1:2200 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4300
Practice Address - Country:US
Practice Address - Phone:972-473-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily