Provider Demographics
NPI:1861103640
Name:KENT, DAWN MICHELLE (CNA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:KENT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17402 ORCHID FALLS LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-2708
Mailing Address - Country:US
Mailing Address - Phone:281-803-9086
Mailing Address - Fax:
Practice Address - Street 1:17402 ORCHID FALLS LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-2708
Practice Address - Country:US
Practice Address - Phone:253-329-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK890452OtherLABOR AND INDUSTRIES (WASHINGTON STATE) INJURIED WORKER COMP