MEDICARE: DANIELLE KENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1144453465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE KENT

Provider Business Mailing Address
First Line	:	PO BOX 1911
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88004-1911
Country	:	US
Telephone Number	:	713-385-3806
Fax Number	:

Provider Business Practice Location Address
First Line	:	6419 REYNOLDS DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-6978
Country	:	US
Telephone Number	:	713-385-3806
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	09/03/2009

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Directions to “ DANIELLE KENT ” Practice Location

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