Individual
KATHLEEN M KISSANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CRNP, MSN
Contact information
Practice address
5500 BUCKEYSTOWN PIKE, FREDERICK, MD 21703-8331
(240) 379-6045
(240) 379-6050
Mailing address
PO BOX 277045, ATLANTA, GA 30384-7045
(240) 566-3330
(240) 566-3892
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R089131
MD
363L00000X
Nurse Practitioner
Primary
R089131
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1257868
AETNA PVN
—
01
—
2221-0247
CERT. DIABETES ED.
MD
Enumeration date
08/29/2005
Last updated
05/17/2011
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