Provider Demographics
NPI:1629382627
Name:KANE, CECELIA CARNESE (RN)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:CARNESE
Last Name:KANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CECELIA
Other - Middle Name:CARNESE
Other - Last Name:WEBBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9560 SUNNEHANNA BLVD APT C202
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-2602
Mailing Address - Country:US
Mailing Address - Phone:850-417-0023
Mailing Address - Fax:
Practice Address - Street 1:9560 SUNNEHANNA BLVD APT C202
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-2602
Practice Address - Country:US
Practice Address - Phone:850-417-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1668162163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse