Provider Demographics
NPI:1417240391
Name:KANNEH, KAHEE (LPN)
Entity Type:Individual
Prefix:
First Name:KAHEE
Middle Name:
Last Name:KANNEH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KAHEE
Other - Middle Name:
Other - Last Name:KANNEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 PARK HILL AVENUE APT #6S
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304
Mailing Address - Country:US
Mailing Address - Phone:347-258-7216
Mailing Address - Fax:
Practice Address - Street 1:141 PARK HILL AVE APT 6S
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4828
Practice Address - Country:US
Practice Address - Phone:347-258-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305196-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse