Provider Demographics
NPI:1619548559
Name:BURNS, KENDRA RENEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:RENEE
Last Name:BURNS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:RENEE
Other - Last Name:PELTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 SKYLAR DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9383
Mailing Address - Country:US
Mailing Address - Phone:681-318-3540
Mailing Address - Fax:
Practice Address - Street 1:206 SKYLAR DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9383
Practice Address - Country:US
Practice Address - Phone:681-318-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0000000363L00000X
WV00000000363LA2100X
WV110094363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care