MEDICARE: JONKEYSHA DESHON KENDRICK FNP-C

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
1	363LF0000X	Family Nurse Practitioner	F09250862	NC

General Provider Information

NPI Number	:	1629941893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONKEYSHA DESHON KENDRICK FNP-C

Provider Business Mailing Address
First Line	:	2359 SPRINGS RD NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-3067
Country	:	US
Telephone Number	:	828-256-9853
Fax Number	:

Provider Business Practice Location Address
First Line	:	2359 SPRINGS RD NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-3067
Country	:	US
Telephone Number	:	828-256-9853
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	01/17/2026

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