Individual provider · Type 1 NPI
Bryan Kavanaugh
Pediatric Registered Nurse · Roseville, MN
NPI number
1033415716
Active
Practice location
2800 Cleveland Ave N
Roseville, MN 55113-1126
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Registered Nurse Primary | 163WP0200X | R191548-2 (MN) |
Pediatric Registered Nurse: Definition to come...
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About NPI 1033415716
Bryan Kavanaugh's National Provider Identifier is 1033415716, issued on Jan 28, 2011. The primary taxonomy on file is Pediatric Registered Nurse (163WP0200X), and the practice location is in Roseville, MN. The record was last updated on Jan 28, 2011.