Provider Demographics
NPI:1568517514
Name:KENT, BRENDA D (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:D
Last Name:KENT
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N CONYER ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4704
Mailing Address - Country:US
Mailing Address - Phone:559-713-1101
Mailing Address - Fax:559-713-1121
Practice Address - Street 1:306 N CONYER ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4704
Practice Address - Country:US
Practice Address - Phone:559-713-1101
Practice Address - Fax:559-713-1121
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ38489Medicare UPIN
CAZZZ01318ZMedicare ID - Type Unspecified