Individual ProviderConstance Cabell KendallNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709(703) 391-3129(703) 295-7669PECOS EnrollmentBased on the most recent information from CMS, provider Constance Cabell Kendall does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1679510325Provider TypeIndividualFull NameKendall, Constance CabellCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date6/1/2006Last Updated3/26/2015Contact InformationPractice LocationPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709Phone(703) 391-3129Fax(703) 391-3006Mailing LocationMailing Address3998 Fair Ridge Rd, Suite 300, Fairfax, VA 22033-2921Phone(703) 295-7669Fax(703) 766-9725Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024138977VirginiaProvider IdentifiersIDDescriptionIssuerID010252644DescriptionMedicaidIssuerUnlistedVirginiaID139180DescriptionOtherIssuerANTHEMVirginiaIDK142DescriptionOtherIssuerCAREFIRST 2005VirginiaID010252407DescriptionMedicaidIssuerUnlistedVirginiaID1679510325DescriptionMedicaidIssuerUnlistedVirginiaID010171253DescriptionMedicaidIssuerUnlistedVirginiaID484645DescriptionOtherIssuerNCPPOVirginia