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NPI Code Detail

MEDICARE: KENEA HAM-RAUDA

MEDICARE:   KENEA  HAM-RAUDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1568070191
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENEA HAM-RAUDA
Provider Business Mailing Address
First Line : 6247 SANTA MARIA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-3322
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6247 SANTA MARIA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-3322
Country : US
Telephone Number : 702-826-7091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2020
Last Update Date : 07/20/2020

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Directions to “ KENEA HAM-RAUDA ” Practice Location

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