Provider Demographics
NPI:1871246140
Name:WHIGHAM, KENDALL BRUNS (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:BRUNS
Last Name:WHIGHAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:KENDALL
Other - Middle Name:ELAINE
Other - Last Name:BRUNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4402 OLD SHELL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4402 OLD SHELL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1912
Practice Address - Country:US
Practice Address - Phone:251-633-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily