Individual
KENDRA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
220 13TH AVENUE PL NW, HICKORY, NC 28601-2532
(828) 328-5646
Mailing address
1723 VALKRIE PL, YORK, SC 29745-6625
(803) 417-6325
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5021664
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
29971
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5021664
NC
Other
Enumeration date
02/13/2025
Last updated
03/02/2026
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