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General NPI Number Information
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NPI Number | 1609061258
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Entity Type | Individual
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Provider Name | KATHLEEN ANN HANLEY FNP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 75 HOUSATONIC ST
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City | LEE
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State | MA
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Zip | 01238-1305
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Country | US
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Telephone | 413-243-0805
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Fax |
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Provider Business Mailing Address
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Address Line | 777 NORTH STREET
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City | PITTSFIELD
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State | MA
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Zip | 01201
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Country | US
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Telephone | 413-395-7694
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 277180
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN277180
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License Number State | MA
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