Individual
DR. JACQUELINE MARIE KENT-MARVICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RN
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(435) 668-6932
Mailing address
2246 S CHEKSHANI CLF, NEW HARMONY, UT 84757-5133
(435) 668-6932
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4904131-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4904131-3102
LICENSE NUMBER
UT
Enumeration date
06/21/2024
Last updated
06/21/2024
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