Individual
KENNETH CHARLES KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
11055 LARSON RANCH RD, RENO, NV 89508-8582
(775) 338-5310
Mailing address
11055 LARSON RANCH RD, RENO, NV 89508-8582
(775) 338-5310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
715327
CA
163W00000X
Registered Nurse
Primary
RN44717
NV
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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