Provider Demographics
NPI:1063645448
Name:KENT, ANNA MARIE (NP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:KENT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:GAAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:7693 WENSLEY LN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7189
Mailing Address - Country:US
Mailing Address - Phone:614-531-5437
Mailing Address - Fax:
Practice Address - Street 1:4600 BOHANNON DR STE 100
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1037
Practice Address - Country:US
Practice Address - Phone:209-677-7468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA711370163W00000X
OH022229363L00000X
CA95007840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-0150193OtherMEDI-CAL