Provider Demographics
NPI:1629133806
Name:BARKER, KENDRA L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:L
Last Name:BARKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 N. PRESTON HIGHWAY
Mailing Address - Street 2:PRESTON HEALTHCARE SERVICES, LLC.
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537
Mailing Address - Country:US
Mailing Address - Phone:304-441-2001
Mailing Address - Fax:304-441-2009
Practice Address - Street 1:1343 N. PRESTON HIGHWAY
Practice Address - Street 2:PRESTON HEALTHCARE SERVICES, LLC.
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537
Practice Address - Country:US
Practice Address - Phone:304-441-2001
Practice Address - Fax:304-441-2009
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV53980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810007542Medicaid
WV3810007542Medicaid
Q73819Medicare UPIN