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Individual

KAWANA BAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
325 S WILDFLOWER DR, GOODYEAR, AZ 85338-6869
(623) 772-5210
Mailing address
3952 N 143RD LN, GOODYEAR, AZ 85395-8426
(623) 281-5967

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
282564
AZ

Other

Enumeration date
10/02/2023
Last updated
11/06/2023
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