Provider Demographics
NPI:1285393165
Name:HARTZOGE, KENDRA DAWN HELMS (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:DAWN HELMS
Last Name:HARTZOGE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 GASTONIA HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-7010
Mailing Address - Country:US
Mailing Address - Phone:704-472-0472
Mailing Address - Fax:
Practice Address - Street 1:1941 GASTONIA HWY
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-7010
Practice Address - Country:US
Practice Address - Phone:704-472-0472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine