Provider Demographics
NPI:1326865163
Name:SAPP KENT, CARLENE NATASHA (LPN)
Entity type:Individual
Prefix:MRS
First Name:CARLENE
Middle Name:NATASHA
Last Name:SAPP KENT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 HARRY T MOORE AVE # 298
Mailing Address - Street 2:
Mailing Address - City:MIMS
Mailing Address - State:FL
Mailing Address - Zip Code:32754-3946
Mailing Address - Country:US
Mailing Address - Phone:321-262-3657
Mailing Address - Fax:
Practice Address - Street 1:2536 HARRY T MOORE AVE
Practice Address - Street 2:
Practice Address - City:MIMS
Practice Address - State:FL
Practice Address - Zip Code:32754-3946
Practice Address - Country:US
Practice Address - Phone:321-262-3657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility