Provider Demographics
NPI:1669012340
Name:MILNE, KESHA (RN)
Entity Type:Individual
Prefix:
First Name:KESHA
Middle Name:
Last Name:MILNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-1244
Mailing Address - Country:US
Mailing Address - Phone:509-548-5885
Mailing Address - Fax:
Practice Address - Street 1:10001 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:PESHASTIN
Practice Address - State:WA
Practice Address - Zip Code:98847-9728
Practice Address - Country:US
Practice Address - Phone:509-548-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60264441163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool