Provider Demographics
NPI:1306939582
Name:KENDRICK, SHEILA LORRAINE
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:LORRAINE
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250216
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-0216
Mailing Address - Country:US
Mailing Address - Phone:313-819-2393
Mailing Address - Fax:248-737-1611
Practice Address - Street 1:6758 WHITE PINE DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3028
Practice Address - Country:US
Practice Address - Phone:248-737-1611
Practice Address - Fax:248-737-1611
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home