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General NPI Number Information
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NPI Number | 1437540911
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Entity Type | Individual
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Provider Name | MRS. KENDRA NOELLE HEAD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 571 ROE CENTER CT
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City | TRAVELERS REST
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State | SC
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Zip | 29690-2013
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Country | US
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Telephone | 864-412-1730
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE STE 300
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City | GREENVILLE
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State | SC
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Zip | 29601-2899
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Country | US
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Telephone | 864-522-8611
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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 | 19299
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License Number State | SC
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