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Individual
CHRISTINE B KAVANAGH
Active
Individual
CHRISTINE B KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN003091
PA
363LP0200X
Pediatric Nurse Practitioner
SP-008251
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP-008251
STATE LICENSE
PA
Enumeration date
05/14/2007
Last updated
09/17/2026
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