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Individual

KATHLEEN ANN KISSANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CLC, IBCLC

Contact information

Practice address
99 E STATE ST, GLOVERSVILLE, NY 12078-1203
(518) 725-8621
Mailing address
PO BOX 143, LAKE PLEASANT, NY 12108-0143
(518) 548-7301

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
269736-1
NY
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
269736-1
NY

Other

Enumeration date
11/20/2017
Last updated
07/10/2019
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