MEDICARE: MRS. GAIL J KAPHAN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	033794-23-01	NH
2	363L00000X	Nurse Practitioner	03379423	NH
3	367A00000X	Advanced Practice Midwife	03379423	NH
4	367A00000X	Advanced Practice Midwife	RN199067	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083778955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAIL J KAPHAN APRN

Provider Business Mailing Address
First Line	:	1985 MAIN ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01103-1095
Country	:	US
Telephone Number	:	413-733-6639
Fax Number	:

Provider Business Practice Location Address
First Line	:	1985 MAIN ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01103-1095
Country	:	US
Telephone Number	:	413-733-6639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	11/23/2016

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