Provider Demographics
NPI:1811654437
Name:KUYKENDALL, JESSICA BEHRENS (RN, MSN, WHNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BEHRENS
Last Name:KUYKENDALL
Suffix:
Gender:F
Credentials:RN, MSN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ANDOVER LN
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-8631
Mailing Address - Country:US
Mailing Address - Phone:256-224-4088
Mailing Address - Fax:
Practice Address - Street 1:1304 13TH AVE SE # SUIEB
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4359
Practice Address - Country:US
Practice Address - Phone:256-355-9216
Practice Address - Fax:256-351-6327
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-150861163W00000X, 163WX0003X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient