Provider Demographics
NPI:1902310972
Name:KENT, WENDY L (AGAC, NP-BC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:KENT
Suffix:
Gender:F
Credentials:AGAC, NP-BC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:L
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGAC, NP-BC
Mailing Address - Street 1:8055 S VANDECAR RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9518
Mailing Address - Country:US
Mailing Address - Phone:989-944-1221
Mailing Address - Fax:
Practice Address - Street 1:1221 SOUTH DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-772-6777
Practice Address - Fax:989-772-6791
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704278094363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner