MEDICARE: MRS. PATRICIA ANN KENTISH

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1558471045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA ANN KENTISH

Provider Business Mailing Address
First Line	:	4258 TASSELWOOD LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1821
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4258 TASSELWOOD LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1821
Country	:	US
Telephone Number	:	713-191-1414
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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