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Kourtney Raven Denino
Psychiatric/Mental Health Nurse Practitioner in Roseburg, Oregon
NPI 1841868015

Kourtney Raven Denino is a Psychiatric/Mental Health Nurse Practitioner based in Roseburg, OR and is specialized in Psychiatric/Mental Health. Kourtney Raven Denino practices in Roseburg, OR. The NPI Number for Kourtney Raven Denino is 1841868015 and holds a License No. 201406969LPN (Oregon).

The current practice location address for Kourtney Raven Denino is 621 W Madrone St, Roseburg, OR and can be reached out via phone at 541-672-2691 and via fax at 833-299-8415.

Location: 621 W Madrone St, Roseburg, OR, 97470-0254
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841868015
Provider Name
Kourtney Raven Denino
Credential
Provider Entity Type
Individual
Gender
Female
Address
621 W Madrone St, Roseburg, OR, 97470-0254
Phone Number
541-672-2691
Fax Number
833-299-8415
Provider Enumeration Date
06/15/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
621 W Madrone St
City
Roseburg
State
Oregon
Zip
97470-3090
Phone Number
541-672-2691
Fax Number
833-299-8415
person
Provider Business Mailing Address Details
Address
621 W Madrone St
City
Roseburg
State
Oregon
Zip
97470-3090
Phone Number
541-672-2691
Fax Number
833-299-8415
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
201406969LPN (Oregon)
Definition
Definition to come...
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