# KATHLEEN M KISSANE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477546117
- **Gender:** F
- **Credential:** RN, CRNP, MSN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | R089131 | MD | — |
| 363L00000X | Nurse Practitioner | R089131 | MD | Yes |

## Other

- **Enumeration date:** 08/29/2005
- **Last updated:** 05/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1257868 | AETNA PVN | — |
| 01 | — | 2221-0247 | CERT. DIABETES ED. | MD |