KATHLEEN ANN CREGAN (NPI# 1861591497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861591497 |
| Entity Type | Individual |
| Full Name | KATHLEEN ANN CREGAN |
| Credential | FNP |
| Practice Address |
4417 Vestal Parkway East Suite 200 Vestal NY 13950-3556 |
| Mailing Address |
346 Grand Ave Johnson City NY 13790-2558 |
| Practice Telephone | 6077971251 |
| Practice Fax Number | 6077294393 |
| Mailing Telephone | 6077198156 |
| Mailing Fax Number | 6077293982 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2012-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
330850 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03142692 | 05 |
| Street Address |
4417 VESTAL PARKWAY EAST SUITE 200 |
| City | VESTAL |
| State | NY |
| Zip Code | 13950-3556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003817057 | Kevin Gallagher | Internal Medicine | 4417 Vestal Parkway East, Suite 201, Vestal, NY 13850-3556 | 2005-08-02 |
| 1033604970 | Panita Pipatnawin | Nurse Practitioner | 4417 Vestal Parkway East, Vestal, NY 13850 | 2018-06-23 |
| 1740537398 | Kelly Elizabeth Miller | Nurse Practitioner | 4417 Vestal Parkway East, Vestal, NY 13850-3556 | 2012-08-13 |
| 1205158508 | Gail Elizabeth Kane | Nurse Practitioner | 4417 Vestal Parkway East, Suite 301, Vestal, NY 13850-3556 | 2010-02-28 |
| 1134358203 | Maria Theresa Bertini | Family Medicine | 4417 Vestal Parkway East, Vestal, NY 13850-3556 | 2009-07-09 |
| 1043449127 | Elizabeth A Rosato | Family Medicine | 4417 Vestal Parkway East, Vestal, NY 13850-3556 | 2009-07-09 |
| 1053495465 | Henda Bouali | Internal Medicine | 4417 Vestal Parkway East, Suite 202, Vestal, NY 13850-3556 | 2006-10-24 |
| 1336192525 | Suzanne Marie Gromniak | Nurse Practitioner | 4417 Vestal Parkway East, Suite 200, Vestal, NY 13850-3556 | 2006-05-18 |
| 1952378705 | Frances C Bidwell | Nurse Practitioner | 4417 Vestal Parkway East, Suite 301, Vestal, NY 13850-3556 | 2006-03-01 |
| 1518955673 | Nancy E Shumeyko | Obstetrics & Gynecology | 4417 Vestal Parkway East, Suite 301, Vestal, NY 13850-3556 | 2005-10-12 |
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| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386006765 | Alison Mizera-micholychak | Nurse Practitioner | 4417 Vestal Pkwy E, Vestal, NY 13850 | 2016-03-24 |
| 1780759464 | Christine Honnick | Nurse Practitioner | 4417 Vestal Pkwy E, Vestal, NY 13850-3556 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709821 | Shu-heng Wang | Nurse Practitioner | 7324 18th Ave, Brooklyn, NY 11204-5678 | 2020-10-29 |
| 1952909012 | Marina Byshovets | Nurse Practitioner | 164 Admiralty Loop, Staten Island, NY 10309-3964 | 2020-10-12 |
| 1700483799 | Dmitry Pediatrics, Pediatric Nurse Practitioner PC | Nurse Practitioner | 10 Shore Blvd Apt 1g, Brooklyn, NY 11235-4022 | 2020-10-03 |
| 1427664572 | Leigh Ann Cohen | Nurse Practitioner | 2 Lincoln Ave Ste 301, Rockville Centre, NY 11570-5775 | 2020-09-23 |
| 1295341436 | Tatiana Margaret Masone | Nurse Practitioner | 3142 Victory Blvd, Staten Island, NY 10314-6717 | 2020-09-22 |
| 1992311567 | Jyneva W Pickel | Nurse Practitioner | 3959 Broadway Rm 722, New York, NY 10032-1559 | 2020-09-19 |
| 1902410186 | Katie Elise Boyd | Nurse Practitioner | 725 Irving Ave Ste 504, Syracuse, NY 13210-1683 | 2020-09-03 |
| 1437763877 | Tiffany Yu | Nurse Practitioner | 1746 W 12th St, Brooklyn, NY 11223-1101 | 2020-09-02 |
| 1134733710 | Khristan Heagle Haller | Nurse Practitioner | 20 Locust Ln, Bronxville, NY 10708-4933 | 2020-09-01 |
| 1831703412 | Marijana Waite | Nurse Practitioner | 6544 Saunders St Apt A7, Rego Park, NY 11374-4209 | 2020-09-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.