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NPI Code Detail

MEDICARE: KENDRA BRENT

MEDICARE: KENDRA BRENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-16350NC

General Provider Information

NPI Number : 1326864893
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA BRENT
Provider Business Mailing Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 252-847-4100
Fax Number :
Provider Business Practice Location Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 423-383-2479
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2024
Last Update Date : 04/13/2026

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Directions to “ KENDRA BRENT ” Practice Location

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