Healthcare Provider Details

I. General information

NPI: 1356245385
Provider Name (Legal Business Name): KRISTY MCCANN DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7417 COLORADO AVE
FORT POLK LA
71459-5322
US

IV. Provider business mailing address

7417 COLORADO AVE
FORT POLK LA
71459-5322
US

V. Phone/Fax

Practice location:
  • Phone: 726-780-0985
  • Fax:
Mailing address:
  • Phone: 726-780-0985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number10237
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: