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General NPI Number Information
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NPI Number | 1306522057
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Entity Type | Individual
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Provider Name | KASSANDRA KENT PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 8200 DODGE ST
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City | OMAHA
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State | NE
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Zip | 68114-4113
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Country | US
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Telephone | 402-955-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 2019 N D ST
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City | FREMONT
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State | NE
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Zip | 68025-3031
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Country | US
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Telephone | 402-200-0197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 3208
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3208
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License Number State | NE
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