Provider Demographics
NPI:1184486763
Name:KENA LLC
Entity type:Organization
Organization Name:KENA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANNAMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:240-460-1146
Mailing Address - Street 1:101 COWARDIN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2078
Mailing Address - Country:US
Mailing Address - Phone:804-643-8863
Mailing Address - Fax:804-596-0397
Practice Address - Street 1:101 COWARDIN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2078
Practice Address - Country:US
Practice Address - Phone:240-460-1146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty