Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | AP7758 | AZ |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 10237129-4405 | UT |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP7758 | AZ |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP7758 | AZ |
NPI | 1326425935 |
---|---|
Provider Name | Keith Wesley Kent |
First Address | Slc, UT 84127-0128 |
Second Address | Logan, UT 84341-2455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2015 |
Last Update Date | 26/03/2021 |