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Individual

RAQUEL RENEE KACIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
3167 WEST BELLTOWER DRIVE, SUITE 120, MERIDIAN, ID 83646
(208) 908-7797
(208) 908-6588
Mailing address
1909 E JADE CREEK LN, EAGLE, ID 83616-7697
(757) 934-4661

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN25040
NV
363LF0000X
Family Nurse Practitioner
Primary
77590
ID
363LF0000X
Family Nurse Practitioner
APRN000865
NV

Other

Enumeration date
09/12/2006
Last updated
10/02/2024
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