Individual provider · Type 1 NPI

Kourtney Raven Denino

Licensed Practical Nurse · Roseburg, OR

NPI number 1841868015 Active

Practice location

621 W Madrone St
Roseburg, OR 97470-3090

Call (541) 672-2691 Map

Fax (833) 299-8415

Mailing address

PO Box 1121
Roseburg, OR 97470-0254

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X201406969LPN (OR)

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 1841868015

Kourtney Raven Denino's National Provider Identifier is 1841868015, issued on Jun 15, 2021. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Roseburg, OR. The record was last updated on Jun 15, 2026.