Kent, Jacqueline Ann
Kent, Jacqueline Ann is an individual health care provider with primary practice located at 4079 Lake Rd N , Brockport NY 14420-1517. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kent, Jacqueline Ann can be contacted via phone (585) 637-0151.Contact Information
Primary practice address
4079 Lake Rd N
Brockport NY 14420-1517
Phone: (585) 637-0151
Fax: (585) 637-0562
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 6742 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 006742 | New York |
Profile Details
| NPI number | 1568454437 |
|---|---|
| LBN Legal business name | Kent, Jacqueline Ann |
| Credentials | RPA-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Jul 5th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568454437 | NPPES |
| New York | MEDICAID | 2605498 | |
| New York | Other | 000925083002 | |
| New York | Other | 109969BF | |
| New York | Other | P019006742 |
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