Edge, Kendra Dian
Edge, Kendra Dian is an individual health care provider with primary practice located at 3333 Silas Creek Pkwy , Winston Salem NC 27103-3013. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Edge, Kendra Dian can be contacted via phone (336) 718-6169.Contact Information
Primary practice address
3333 Silas Creek Pkwy
Winston Salem NC 27103-3013
Phone: (336) 718-6169
Fax: (336) 718-6190
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 102842 | North Carolina |
Profile Details
| NPI number | 1659351914 |
|---|---|
| LBN Legal business name | Edge, Kendra Dian |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Jun 30th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659351914 | NPPES |
| North Carolina | MEDICAID | 8101870 | |
| North Carolina | Other | 1285682310 |
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