Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kendra Marie Gordon

Individual provider Primary Care Nurse Practitioner · NPI 1104712801

Kendra Marie Gordon is a Nurse Practitioner in Charleston, South Carolina. Qualified in 2025, 1 year ago. Licensed in South Carolina.

Years since qualifying
1
Licensed in
SC
In the registry since
2025

Practice location Address checks out

171 Ashley Ave
Charleston, SC 29425-8900
Phone: (843) 792-1414
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 30532 (SC)

Record details

NPI number1104712801
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 17, 2025
Last updated in NPPESJuly 12, 2025
Certification dateJuly 12, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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