Provider Demographics
NPI:1083269401
Name:POWERS, KENDRA REBECCA (DNP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:REBECCA
Last Name:POWERS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:POWERS
Other - Last Name:HOOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1910 MADISON AVE # 2628
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2620
Mailing Address - Country:US
Mailing Address - Phone:901-352-8994
Mailing Address - Fax:440-294-8182
Practice Address - Street 1:1910 MADISON AVE # 2628
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2620
Practice Address - Country:US
Practice Address - Phone:901-352-8994
Practice Address - Fax:440-294-8182
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR212499363LP0808X
TN26308363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health