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General NPI Number Information
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NPI Number | 1194437806
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Entity Type | Individual
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Provider Name | KENDALL CHRISTINE JUKKA NP
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Gender | Female
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 110 KILDAIRE PARK DR
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City | CARY
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State | NC
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Zip | 27518-8162
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Country | US
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Telephone | 919-235-6466
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 TRIBUTE CENTER DR APT 235
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City | RALEIGH
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State | NC
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Zip | 27612-3226
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Country | US
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Telephone | 661-644-4561
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95023560
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5019665
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License Number State | NC
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