NPI 1306240429 · live from the CMS NPI Registry
Kimberly Reardon Banigan, CPNP
Nurse Practitioner, Pediatrics in Boston, MA. National Provider Identifier 1306240429, active.
NPI record
| NPI | 1306240429 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 300 Longwood Ave, Boston, MA 02115 |
| Practice phone | 617-355-6162 |
| Enumerated | October 17, 2014 |
| Last updated | August 28, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | 209011064 (IL) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | RN2316271 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.