Provider Demographics
NPI:1134117963
Name:KENT, GLORIA LEE (RN,CNP)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:LEE
Last Name:KENT
Suffix:
Gender:F
Credentials:RN,CNP
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:100 MISSION BOULEVARD
Practice Address - Street 2:SUITE 2800
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2147
Practice Address - Country:US
Practice Address - Phone:209-257-0177
Practice Address - Fax:209-257-0176
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2015-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA226867/12812363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health