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General NPI Number Information
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NPI Number | 1184486763
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Entity Type | Organization
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Legal Business Name | KENA LLC
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 101 COWARDIN AVE
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City | RICHMOND
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State | VA
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Zip | 23224-2078
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Country | US
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Telephone | 240-460-1146
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Fax |
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Provider Business Mailing Address
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Address Line | 101 COWARDIN AVE STE 101
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City | RICHMOND
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State | VA
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Zip | 23224-2078
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Country | US
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Telephone | 804-643-8863
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Fax | 804-596-0397
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | AKENA WANNAMAKER
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Credential | DPM
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Telephone | 240-460-1146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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