Provider Demographics
NPI:1548972649
Name:KENDALL, JESSIE ABIGAIL (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:ABIGAIL
Last Name:KENDALL
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 AMQUIWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2656
Mailing Address - Country:US
Mailing Address - Phone:303-523-5545
Mailing Address - Fax:
Practice Address - Street 1:461 21ST AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37240-1104
Practice Address - Country:US
Practice Address - Phone:615-322-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10030592163W00000X, 363LP0808X
TN266142163W00000X
TN34847363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse