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Raven Kennedy
NPI 1770338584 · on the registry since 2024
Practice
- Address
- 220 W Georgia Ave
Nampa, ID 83686 - Phone
- (208) 960-7474
- Clinicians at this address
- 97
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- CO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-04-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho