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General NPI Number Information
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NPI Number | 1265228472
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Entity Type | Organization
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Legal Business Name | KNH ADVANCED PRACTICE NURSING INC.
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 9493 GARFIELD ST
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City | RIVERSIDE
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State | CA
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Zip | 92503-3765
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Country | US
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Telephone | 951-965-9313
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Fax |
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Provider Business Mailing Address
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Address Line | 19637 MARIPOSA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92508-9634
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Country | US
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Telephone | 951-965-9313
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KEENA HARRISON
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Credential | PMHNP
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Telephone | 951-965-9313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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