Provider Demographics
NPI:1295973527
Name:AVENT, KATRENA L (LPN)
Entity type:Individual
Prefix:
First Name:KATRENA
Middle Name:L
Last Name:AVENT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2531
Mailing Address - Country:US
Mailing Address - Phone:716-481-3277
Mailing Address - Fax:716-464-3252
Practice Address - Street 1:5 BROOKHAVEN DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-2531
Practice Address - Country:US
Practice Address - Phone:716-481-3277
Practice Address - Fax:716-464-3252
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275463-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse