Provider Demographics
NPI:1043550494
Name:TOLON, KENDA SHAVON (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KENDA
Middle Name:SHAVON
Last Name:TOLON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5844 NW BARRY RD
Mailing Address - Street 2:STE. 110
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1465
Mailing Address - Country:US
Mailing Address - Phone:816-880-6100
Mailing Address - Fax:816-746-1226
Practice Address - Street 1:5844 NW BARRY RD
Practice Address - Street 2:STE. 110
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1465
Practice Address - Country:US
Practice Address - Phone:816-880-6100
Practice Address - Fax:816-746-1226
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013006960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily