Provider Demographics
NPI:1114333028
Name:ESSEX, KENDALL ELLINGTON (FNP)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:ELLINGTON
Last Name:ESSEX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 S SHERWOOD FRST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4363
Mailing Address - Country:US
Mailing Address - Phone:225-367-6189
Mailing Address - Fax:225-456-2301
Practice Address - Street 1:3907 S SHERWOOD FOREST BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4363
Practice Address - Country:US
Practice Address - Phone:225-367-6189
Practice Address - Fax:225-456-2301
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2017-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07824363LF0000X
TXAP133526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily