Provider Demographics
NPI:1366729311
Name:WINES, KENDALL DENISE (APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:KENDALL
Middle Name:DENISE
Last Name:WINES
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4642 N LOOP 289 STE 101
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-2422
Mailing Address - Country:US
Mailing Address - Phone:806-797-4985
Mailing Address - Fax:806-792-8588
Practice Address - Street 1:4642 N LOOP 289 STE 101
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-2422
Practice Address - Country:US
Practice Address - Phone:806-797-4985
Practice Address - Fax:806-792-8588
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX774690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily