MEDICARE: TONI KENION FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5013388	NC

General Provider Information

NPI Number	:	1558987222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI KENION FNP

Provider Business Mailing Address
First Line	:	258 SOUTHTOWN CIR
Second Line	:
City	:	ROLESVILLE
State	:	NC
Zip	:	27571-9593
Country	:	US
Telephone Number	:	919-435-1185
Fax Number	:	919-435-8548

Provider Business Practice Location Address
First Line	:	258 SOUTHTOWN CIR
Second Line	:
City	:	ROLESVILLE
State	:	NC
Zip	:	27571-9593
Country	:	US
Telephone Number	:	919-435-1185
Fax Number	:	919-435-8548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2020
Last Update Date	:	03/28/2024

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