Provider Demographics
NPI:1801436241
Name:PAXTON, KENDRA LEE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:LEE
Last Name:PAXTON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:LEE
Other - Last Name:TRAVIS-PAXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:6361 PILOT KNOB AVE NE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9252
Mailing Address - Country:US
Mailing Address - Phone:330-412-3550
Mailing Address - Fax:
Practice Address - Street 1:141 N FORGE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1407
Practice Address - Country:US
Practice Address - Phone:330-375-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024545363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner