Individual
COKY ANN KERNODLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
5767 HWY 135, STONEVILLE, NC 27048-2704
(336) 445-4004
(336) 445-0148
Mailing address
244 HOMESTEAD DR, STONEVILLE, NC 27048-7551
(336) 327-9438
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
A00003430
NC
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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