Provider Demographics
NPI:1578501607
Name:KENT, DAVID W (CRNA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:KENT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-385-3704
Mailing Address - Fax:615-292-1321
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 435
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:615-292-1321
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN11443367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0066755000Medicaid
WV001721136OtherWV BLUE CROSS PROVIDER #
WV550696369OtherWV WORKERS PROVIDER #
OH8205413Medicare PIN
WV8205412Medicare PIN