Provider Demographics
NPI:1578364667
Name:ROLAND, KENDRA MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:MICHAEL
Last Name:ROLAND
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 LEE CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7031
Mailing Address - Country:US
Mailing Address - Phone:605-381-0401
Mailing Address - Fax:
Practice Address - Street 1:5516 LEE CIR
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7031
Practice Address - Country:US
Practice Address - Phone:605-381-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program