Provider Demographics
NPI:1013902337
Name:KANEY, RICHARD STEPHEN (FNP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEPHEN
Last Name:KANEY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 NICOLE LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1623
Mailing Address - Country:US
Mailing Address - Phone:530-891-4843
Mailing Address - Fax:
Practice Address - Street 1:CALIFORNIA STATE UNIVERSITY, CHICO
Practice Address - Street 2:STUDENT HEALTH SERVICES
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95929-0001
Practice Address - Country:US
Practice Address - Phone:530-898-4561
Practice Address - Fax:530-898-4057
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN288812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily