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Individual
MISS GILAINE KAVANAGHT
Active
Individual
MISS GILAINE KAVANAGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
170652
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750493706
—
NY
Enumeration date
09/01/2010
Last updated
09/01/2010
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