Individual
KENDRA JO BACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
448 CRANBERRY ST, NEWLAND, NC 28657-8800
(828) 737-0221
(828) 737-0321
Mailing address
PO BOX 1490, BOONE, NC 28607-0682
(828) 262-3886
(833) 665-5329
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9212674
FL
363LF0000X
Family Nurse Practitioner
28417
TN
363LF0000X
Family Nurse Practitioner
Primary
5021586
NC
363LF0000X
Family Nurse Practitioner
APN.0991706-NP
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
041572779
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209031861
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
28417
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN9212674
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN297601
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041572779
STATE OF IL APRN LICENSE
IL
01
—
297601
STATE OF GA APRN LICENSE
GA
01
—
5021586
STATE OF NC APRN
NC
05
—
65122071
—
CO
01
—
ARNP9212674
STATE OF FLORIDA ARNP LICENSE
FL
01
—
Y0EZQ
FLORIDA BLUE-BCBS
FL
Enumeration date
08/29/2012
Last updated
12/09/2025
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