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General NPI Number Information
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NPI Number | 1043832116
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Entity Type | Individual
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Provider Name | KATHLEEN A KANG NP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 3300 MAIN STREET
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City | SPRINGFIELD
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State | MA
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Zip | 01107-1112
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Country | US
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Telephone | 413-794-5600
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Fax | 413-794-7297
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Provider Business Mailing Address
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Address Line | 280 CHESTNUT STREET 2ND FL
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City | SPRINGFIELD
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State | MA
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Zip | 01199-1001
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Country | US
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Telephone | 413-794-5700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN10015428
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 170531
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9116
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License Number State | CT
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