Healthcare Provider Details

I. General information

NPI: 1134531536
Provider Name (Legal Business Name): JONI NICOLE SESSOR-KENDRICK WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 S JEFFERSON ST
ROANOKE VA
24016-4404
US

IV. Provider business mailing address

1107B BROOKDALE ST
MARTINSVILLE VA
24112-4501
US

V. Phone/Fax

Practice location:
  • Phone: 540-985-9998
  • Fax:
Mailing address:
  • Phone: 276-634-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024171603
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: