Healthcare Provider Details

I. General information

NPI: 1376486266
Provider Name (Legal Business Name): KENDAL MARIE PARKINS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 DRY HILL RD
BECKLEY WV
25801-2605
US

IV. Provider business mailing address

824 GROVES RD
CANVAS WV
26662-4025
US

V. Phone/Fax

Practice location:
  • Phone: 304-253-6060
  • Fax:
Mailing address:
  • Phone: 681-205-4234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number112722
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: