Individual
RUTH KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4374, MCCALL, ID 83638-8374
(208) 315-2092
Mailing address
PO BOX 4374, MCCALL, ID 83638-8374
(208) 315-2092
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487251518
—
ID
Enumeration date
02/09/2021
Last updated
02/09/2021
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