Provider Demographics
NPI:1457670614
Name:BATTEN, KENDRA MICHON
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MICHON
Last Name:BATTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-676-4147
Mailing Address - Fax:336-285-8322
Practice Address - Street 1:1730 KERNERSVILLE MEDICAL PKWY STE 101
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7198
Practice Address - Country:US
Practice Address - Phone:336-564-4950
Practice Address - Fax:336-564-4959
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3693103T00000X
NCL006645133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No103T00000XBehavioral Health & Social Service ProvidersPsychologist