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General NPI Number Information
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NPI Number | 1134886682
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Entity Type | Individual
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Provider Name | KENDYL DURHAM PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 3554 CHAIN BRIDGE RD STE 200
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City | FAIRFAX
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State | VA
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Zip | 22030-2709
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Country | US
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Telephone | 703-896-7628
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Fax | 703-890-2359
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Provider Business Mailing Address
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Address Line | 7017 CHRISTIAN LOOP UNIT A
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City | FORT MEADE
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State | MD
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Zip | 20755-4538
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Country | US
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Telephone |
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Fax | 240-465-1266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 50017029
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License Number State | NC
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