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General NPI Number Information
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NPI Number | 1568454437
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Entity Type | Individual
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Provider Name | JACQUELINE ANN KENT RPA-C
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 5901 LAC DE VILLE BLVD
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City | ROCHESTER
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State | NY
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Zip | 14618-5600
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Country | US
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Telephone | 585-442-7960
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 WINTON RD S STE 100
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City | ROCHESTER
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State | NY
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Zip | 14618-4011
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6742
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License Number State | NY
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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 | 006742
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License Number State | NY
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