Individual
MR. KEVIN JOSEPH LUNDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
106 TABOR XING, TABOR CITY, NC 28463-2705
(910) 653-1901
Mailing address
PO BOX 6149, ALOHA, OR 97007-0149
(503) 352-8657
(503) 352-8658
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
201904622NP-PP
OR
363LF0000X
Family Nurse Practitioner
Primary
95017624
CA
363LF0000X
Family Nurse Practitioner
F10171373
PA
Other
Enumeration date
02/08/2018
Last updated
09/16/2021
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