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Individual

BRENDA ELLEN KENTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, WCC

Contact information

Practice address
682 LANCASTER LANE, AFTON, WY 83110
(509) 449-0141
Mailing address
682 LANCASTER LANE, PO BX 663, AFTON, WY 83110
(509) 449-0141

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
28304
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4140801
NATIONAL ALLIANCE OF WOUND CARE
WY
Enumeration date
12/17/2010
Last updated
12/17/2010
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