Individual
KENDRA SCHERRIE BLACKEAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-2715
(704) 699-2453
Mailing address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-2715
(704) 699-2453
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
328087
NC
367500000X
Certified Registered Nurse Anesthetist
4704287475
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
6506
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801177621
INDIVIDUAL
NC
01
—
4704287475
MI LICENSE
MI
Enumeration date
09/07/2011
Last updated
04/25/2025
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