Individual
TARA KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
577 WESTERN AVE, HEALTH SERVICES SCANLON BUILDING, WESTFIELD, MA 01085-2580
(413) 572-5415
(413) 572-5545
Mailing address
577 WESTERN AVE, WESTFIELD STATE COLLEGE HEALTH SERVICES, WESTFIELD, MA 01085-2580
(413) 572-5415
(413) 572-5545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
258223
MA
Other
Enumeration date
11/02/2006
Last updated
12/26/2007
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