Provider Demographics
NPI:1972530343
Name:KANE, PATRICIA ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:KANE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:VEHOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3175 WEST WARD ROAD
Mailing Address - Street 2:#200
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3024
Mailing Address - Country:US
Mailing Address - Phone:410-286-0664
Mailing Address - Fax:410-286-2834
Practice Address - Street 1:3175 WEST WARD ROAD
Practice Address - Street 2:#200
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3024
Practice Address - Country:US
Practice Address - Phone:410-286-0664
Practice Address - Fax:410-286-2834
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162203363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408380600Medicaid
MD377MJ119Medicare PIN