Provider Demographics
NPI:1639069370
Name:WHITFORD, KENNADIE (RN)
Entity type:Individual
Prefix:
First Name:KENNADIE
Middle Name:
Last Name:WHITFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KENNADIE
Other - Middle Name:TANERA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3240 HAVEN RIDGE CT APT 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-0335
Mailing Address - Country:US
Mailing Address - Phone:702-683-9851
Mailing Address - Fax:
Practice Address - Street 1:3240 HAVEN RIDGE CT APT 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-0335
Practice Address - Country:US
Practice Address - Phone:702-683-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV846013163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health