Provider Demographics
NPI:1194597302
Name:KENER, DAISY
Entity type:Individual
Prefix:DR
First Name:DAISY
Middle Name:
Last Name:KENER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N SANDHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-4797
Mailing Address - Country:US
Mailing Address - Phone:702-803-7940
Mailing Address - Fax:
Practice Address - Street 1:350 N SANDHILL BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-4797
Practice Address - Country:US
Practice Address - Phone:702-803-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist