Individual provider · Type 1 NPI
Mary Laree Kenworthy
Licensed Practical Nurse · Boise, ID
NPI number
1487267266
Active
Practice location
500 W Fort St Bldg 88
Boise, ID 83702-4598
Fax (208) 422-1591
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse | 164W00000X | 8104 (ID) |
| Licensed Practical Nurse Primary | 164W00000X | PN8104 (ID) |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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About NPI 1487267266
Mary Laree Kenworthy's National Provider Identifier is 1487267266, issued on Aug 31, 2020. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Boise, ID. The record was last updated on Aug 31, 2020.