Kendra Diann Maynard, RN
Individual provider Active NPI Registered Nurse · Gainesboro, TN
NPI 1962764514 · NPPES record last updated Jun 11, 2012
Key facts
- NPI
- 1962764514
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN0000185891 (TN)
- Practice address
- 600 N Murray St
Gainesboro, TN 38562-9313 - Phone
- (931) 268-0218
- Fax
- (931) 268-0872
- NPI assigned
- Jun 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000185891 | TN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN0000185891 | TN | Yes |
Addresses
Primary practice location
600 N Murray St
Gainesboro, TN 38562-9313
Mailing address
600 N Murray St
Gainesboro, TN 38562-9313
Phone (931) 268-0218
Other providers in Gainesboro, TN
- Jackson County Medical Center LLC
- Teneal Faye Jenkins
- Travis Jones
- Jennifer Keith
- Kristi Malena Lafever
- Alexa Allison Miller
- Courtney Roberts
- Kursten McKenzie Roop
- Heather Stafford
- Kelsie Stafford
All providers in Gainesboro, TN · Registered Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.