IndividualActive
Kendra Gordon
NPI 1104712801 · Primary Care Nurse Practitioner · Charleston, SC
Provider details
- NPI number
- 1104712801
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 30532 (SC)
Mailing address
Po Box 751461
Charlotte, NC 28275-1461
Registry dates
- Enumerated
- 2025-06-17
- Last updated
- 2025-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.