Provider Demographics
NPI:1558841411
Name:KENT, NICHOLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:KENT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 S ALMA SCHOOL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4405
Mailing Address - Country:US
Mailing Address - Phone:480-313-6283
Mailing Address - Fax:
Practice Address - Street 1:3225 S ALMA SCHOOL RD STE 104
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-3763
Practice Address - Country:US
Practice Address - Phone:480-313-6283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN170616163W00000X
AZAP11255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse