Kendra Waldroup, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

L-61023 Issued in TX

Practice address

3440 Vagas Drive
Paris, TX 75460

Phone

(903) 272-5698

NPI assigned

Nov 13, 2014

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1609272079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 93",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "75461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 VAGAS DRIVE",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "75460",
            "telephone_number": "903-272-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROUP",
        "first_name": "KENDRA",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "L-61023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Walgreen Co (Walgreens #07242)
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• Murray Walker
• Deborah Kaye Wall, LPC
• Stephen Walter, MD

• Lactation Consultant (Registered Nurse) in Paris, TX
• Providers in Paris, TX by specialty
• Lactation Consultant (Registered Nurse) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.