Most Relevant Information
Provider Data
| NPI Number: | 1003184607 |
| Provider Name: | DWAN RENEE KENDRICK RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | R035704 |
Most Important Dates
| Enumeration Date: | 12/09/2011 |
| Last Updated: | 12/12/2011 |
Provider Practice Location
210 FIRST STREET
WANBLEE
SD
57577
Practice Location Phone/Fax
| Phone: | 6054626155 |
| Fax: |
Provider Mailing Location
PO BOX 290
WANBLEE
SD
575770290
Provider Mailing Phone/Fax
| Phone: | 6054626155 |
| Fax: |