MEDICARE: RONALD KENAN CASE MANAGER

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
1	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1922605229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD KENAN CASE MANAGER

Provider Business Mailing Address
First Line	:	8967 CYPRESS FOG CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-3243
Country	:	US
Telephone Number	:	808-222-8431
Fax Number	:

Provider Business Practice Location Address
First Line	:	8967 CYPRESS FOG CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-3243
Country	:	US
Telephone Number	:	808-222-8431
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2020
Last Update Date	:	06/24/2026

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