Provider Demographics
NPI:1114301793
Name:KENT, ALEXANDRA BARRETT (MSN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:BARRETT
Last Name:KENT
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:BARRETT
Other - Last Name:LUCIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:36 NASSAU AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2118
Mailing Address - Country:US
Mailing Address - Phone:774-262-7596
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672428163WE0003X
NY339858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency