Kenn Maceren
Registered Nurse in Colton, CA. Individual provider (NPI-1).
NPI number1982253050
StatusActive
Last updated in NPPESSep 10, 2019
Details
- NPI
- 1982253050
- Entity type
- Individual (NPI-1)
- Name
- Kenn Maceren
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 10, 2019
- Last updated
- Sep 10, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 801251 | CA | Yes |
Practice location
400 N Pepper AveColton, CA 92324-1801
Phone 909-580-3145
Mailing address
400 N Pepper AveColton, CA 92324-1801
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