Provider Demographics
NPI:1790129138
Name:KENT, JOYCE MARIE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIE
Last Name:KENT
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:MARIE
Other - Last Name:TYEPTANAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2113 35TH ST
Mailing Address - Street 2:
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-1631
Mailing Address - Country:US
Mailing Address - Phone:920-242-9436
Mailing Address - Fax:
Practice Address - Street 1:2113 35TH ST
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-1631
Practice Address - Country:US
Practice Address - Phone:920-242-9436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15698-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health