Provider Demographics
NPI:1215606405
Name:KENT, KAYLA RAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:RAE
Last Name:KENT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:RAE
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8112 EATON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-1516
Mailing Address - Country:US
Mailing Address - Phone:317-516-7794
Mailing Address - Fax:
Practice Address - Street 1:8112 EATON CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-1516
Practice Address - Country:US
Practice Address - Phone:317-516-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28254188A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse