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Individual
KENDRA DIAN EDGE
Active
Individual
KENDRA DIAN EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102842
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285682310
WSCA GRP NPI #
NC
05
—
8101870
—
NC
Enumeration date
01/20/2006
Last updated
07/29/2024
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