Provider Demographics
NPI:1053447912
Name:MCDONNELL KENT, NANCY (ANP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MCDONNELL KENT
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 PALMER WASILLA HWY
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7236
Mailing Address - Country:US
Mailing Address - Phone:907-352-6600
Mailing Address - Fax:907-376-3096
Practice Address - Street 1:3223 PALMER WASILLA HWY
Practice Address - Street 2:SUITE # 3
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7236
Practice Address - Country:US
Practice Address - Phone:907-352-6600
Practice Address - Fax:907-376-3096
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK176363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner