Individual
KRISTEN L CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 988-0000
(717) 782-5716
Mailing address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 988-0000
(717) 782-5716
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA003255
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103190636
—
PA
Enumeration date
03/17/2014
Last updated
01/16/2021
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