Provider Demographics
NPI:1780567461
Name:STINSON, KENDRA JETER (FNP-C)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:JETER
Last Name:STINSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LEE ROAD 2003 ANX
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-8666
Mailing Address - Country:US
Mailing Address - Phone:334-220-7771
Mailing Address - Fax:
Practice Address - Street 1:22 LEE ROAD 2003 ANX
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36870-8666
Practice Address - Country:US
Practice Address - Phone:334-220-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily