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NPI Code Detail

MEDICARE: KENDA SUTTON-EL

MEDICARE: KENDA SUTTON-EL
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
1133NN1002XNutrition Education NutritionistVA
2172V00000XCommunity Health Worker
3174N00000XLactation Consultant (Non-RN)
4246RP1900XPhlebotomy Technician
5374J00000XDoula

General Provider Information

NPI Number : 1477056489
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDA SUTTON-EL
Provider Business Mailing Address
First Line : 115 E BROAD ST UNIT 1A
Second Line :
City : RICHMOND
State : VA
Zip : 23219-1791
Country : US
Telephone Number : 804-316-9867
Fax Number :
Provider Business Practice Location Address
First Line : 115 E BROAD ST
Second Line :
City : RICHMOND
State : VA
Zip : 23219-1791
Country : US
Telephone Number : 804-840-6435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2018
Last Update Date : 01/18/2023

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Directions to “ KENDA SUTTON-EL ” Practice Location

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