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Individual
KENNETH CHARLES KAVANAUGH
Active
Individual
KENNETH CHARLES KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
715327
CA
163W00000X
Registered Nurse
Primary
RN44717
NV
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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