Alta Blanche Kendall, ARNP NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

AP60289316 Issued in WA

Practice address

3900 Capital Mall Dr SW
Olympia, WA 98502-8654

Phone

(360) 704-4743

NPI assigned

Apr 25, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Capital Medical Center Specialty Physicians, LLC

  • Occupational Medicine Physician
  • Olympia, WA
  • NPI 1760785281
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  NPD
• Multicare Health System

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1730687161
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1104246388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "address_2": "TACOMA GENERAL HOSPITAL-PEDIATRIX MEDICAL GROUP",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-403-1019",
            "fax_number": "253-403-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CAPITAL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "360-704-4743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Martin Luther King Jr Way",
            "address_2": "Tacoma General Hospital-Pediatrix Medical Group",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054234",
            "country_code": "US",
            "telephone_number": "253-403-1019",
            "fax_number": "253-403-1686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "ALTA",
        "middle_name": "BLANCHE",
        "credential": "ARNP NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "AP60289316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Ford Kelso, MSW
• Lauren Kelson, PA
• Michael R. Kelson, D.D.S.
• Stephen Mathew Kelson, D.D.S., M.D.
• Ken P Lee MD PLLC
• Josefina Kender
• Jeffrey Lee Kendig, LPN
• Tracy Colleen Kenela, M.A., LMHC, CRC
• Amber Kenison
• Doris Paculanang Kenna, RN

• Neonatal Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Neonatal Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.