Provider Demographics
NPI:1285634170
Name:DANN, KATHLEEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:K
Last Name:DANN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 8019
Mailing Address - Street 2:VALLEY MEDICAL GROUP, PC
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01102-8000
Mailing Address - Country:US
Mailing Address - Phone:866-431-4077
Mailing Address - Fax:413-774-7448
Practice Address - Street 1:31 HALL DR
Practice Address - Street 2:AMHERST MEDICAL CENTER
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2751
Practice Address - Country:US
Practice Address - Phone:413-256-8561
Practice Address - Fax:413-256-4421
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2008-06-09
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Provider Licenses
StateLicense IDTaxonomies
MA54868207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA710700OtherHPHC
MA102720OtherCIGNA
MA24212OtherHNE
MA054868OtherTUFTS
MA6197809Medicaid
MAJ04703OtherBLUE CROSS & BLUE SHIELD
MA000000008361OtherBMC
MA2345700OtherAETNA
MA2211723 03OtherUNITED HEALTH CARE
MA1293472OtherFALLON
MAJ04703OtherBLUE CROSS & BLUE SHIELD
MAA57990Medicare UPIN