Individual
KATHLEEN KIM BANES-LECLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
963 LANE AVE, CHULA VISTA, CA 91914-3501
(615) 693-9245
Mailing address
4605 OLNEY ST APT 3, SAN DIEGO, CA 92109-3668
(619) 750-3447
Taxonomy
Speciality
Code
Description
License number
State
163WD1100X
Peritoneal Dialysis Registered Nurse
Primary
535791
CA
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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