Provider Demographics
NPI:1194435974
Name:THURSTON, KENDALL KOHL (RN)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:KOHL
Last Name:THURSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2644
Mailing Address - Country:US
Mailing Address - Phone:772-263-6068
Mailing Address - Fax:
Practice Address - Street 1:1740 SE 18TH ST STE 1102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5447
Practice Address - Country:US
Practice Address - Phone:352-512-0092
Practice Address - Fax:352-512-0093
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11042444363L00000X
FLRN9538574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner