Provider Demographics
NPI:1346812880
Name:KENDRICK, LESLIE FAYE (DNP)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:FAYE
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:860 OMNI BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-223-9794
Mailing Address - Fax:757-223-9168
Practice Address - Street 1:860 OMNI BLVD STE 110
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4430
Practice Address - Country:US
Practice Address - Phone:757-223-9794
Practice Address - Fax:757-223-9168
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024181639363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty