Provider Demographics
NPI:1558433805
Name:KENT, SARA E (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:E
Last Name:KENT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4626
Mailing Address - Country:US
Mailing Address - Phone:401-941-2830
Mailing Address - Fax:401-941-6886
Practice Address - Street 1:43 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-1027
Practice Address - Country:US
Practice Address - Phone:401-941-2830
Practice Address - Fax:401-941-6886
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA000969363AM0700X
VA00110002413363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical