Provider Demographics
NPI:1285899138
Name:ROLOFF, KENDRA LEIGH (ARNP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:LEIGH
Last Name:ROLOFF
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:LEIGH
Other - Last Name:KNODEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 N 11TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1210
Mailing Address - Country:US
Mailing Address - Phone:701-751-2272
Mailing Address - Fax:701-751-0974
Practice Address - Street 1:14355 MIRANDA WAY
Practice Address - Street 2:
Practice Address - City:LOS ALTOS HILLS
Practice Address - State:CA
Practice Address - Zip Code:94022-2032
Practice Address - Country:US
Practice Address - Phone:701-989-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296582363LW0102X
TX1130981363LW0102X
FLARNP9278854363LX0001X
NDR33969363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND19953Medicaid
ND714159Medicare PIN