Provider Demographics
NPI:1235177031
Name:BECKER-MUSANTE, KENDRA A (APRN,NMD)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:A
Last Name:BECKER-MUSANTE
Suffix:
Gender:F
Credentials:APRN,NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5919 APPROACH RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5720
Mailing Address - Country:US
Mailing Address - Phone:860-572-7711
Mailing Address - Fax:860-574-9014
Practice Address - Street 1:5919 APPROACH RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5720
Practice Address - Country:US
Practice Address - Phone:860-572-7711
Practice Address - Fax:860-574-9014
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3736363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00344OtherLICENSE