Healthcare Provider Details

I. General information

NPI: 1851127245
Provider Name (Legal Business Name): MICHAEL O KANE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 WHITE MOUNTAIN HWY STE 105
NORTH CONWAY NH
03860-5147
US

IV. Provider business mailing address

1976 WHITE MOUNTAIN HWY STE 105
NORTH CONWAY NH
03860-5147
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-4940
  • Fax: 603-371-3250
Mailing address:
  • Phone: 603-356-4940
  • Fax: 603-371-3250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number082670-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number082670-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: