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1841868015
KOURTNEY RAVEN DENINO
ROSEBURG, OR
NPI
1841868015
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OR 201406969LPN)
Enumeration Date
2021-06-15
Last Update Date
2021-06-15
Business Address
KOURTNEY RAVEN DENINO
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
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Mailing Address
KOURTNEY RAVEN DENINO
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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