Provider Demographics
NPI:1083205611
Name:KENT, HOLLY KAYLA (APRN,PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:KAYLA
Last Name:KENT
Suffix:
Gender:F
Credentials:APRN,PMHNP-BC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:KAYLA
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:140 N MADISON AVE PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8015
Mailing Address - Country:US
Mailing Address - Phone:859-972-7800
Mailing Address - Fax:
Practice Address - Street 1:139 TROON CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8015
Practice Address - Country:US
Practice Address - Phone:859-200-5392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015720363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty