Provider Demographics
NPI:1891370607
Name:LAMBERT, KENDALL BROOKE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:BROOKE
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:BROOKE
Other - Last Name:FETHEROL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:240 CAPITOL ST STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2297
Mailing Address - Country:US
Mailing Address - Phone:304-344-1623
Mailing Address - Fax:304-344-5853
Practice Address - Street 1:1081 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-9848
Practice Address - Country:US
Practice Address - Phone:304-842-4135
Practice Address - Fax:304-842-4398
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV108700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily