Provider Demographics
NPI:1912426446
Name:KENT-HINES, PATRICIA CAROLYN (LPN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CAROLYN
Last Name:KENT-HINES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:CAROLYN
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4095 AMERICAN WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-8339
Mailing Address - Country:US
Mailing Address - Phone:901-271-9500
Mailing Address - Fax:865-342-0120
Practice Address - Street 1:4095 AMERICAN WAY STE 1
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-8339
Practice Address - Country:US
Practice Address - Phone:901-271-9500
Practice Address - Fax:865-342-0120
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN78592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse