Provider Demographics
NPI:1811489297
Name:FINK, KENDRA (OD)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:FINK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:HARBISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1815 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-1236
Mailing Address - Country:US
Mailing Address - Phone:308-529-2836
Mailing Address - Fax:
Practice Address - Street 1:211 N SPRUCE ST
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-2552
Practice Address - Country:US
Practice Address - Phone:308-284-4394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1483152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist