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General NPI Number Information
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NPI Number | 1609293836
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Entity Type | Individual
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Provider Name | BIANCA KENYON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 8100 ASHTON AVE STE 200
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City | MANASSAS
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State | VA
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Zip | 20109-5688
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Country | US
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Telephone | 571-581-1771
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Fax |
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Provider Business Mailing Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-0001
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Country | US
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Telephone |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101284134
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101284134
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License Number State | VA
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