Provider Demographics
NPI:1760517296
Name:HORGAN, KATHLEEN ANN (CNM)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:HORGAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:MCGLOIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:445 BROADWAY
Mailing Address - Street 2:1M
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2314
Mailing Address - Country:US
Mailing Address - Phone:914-478-3414
Mailing Address - Fax:
Practice Address - Street 1:20 SOUTH BROADWAY
Practice Address - Street 2:PLANNED PARENTHOOD
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3713
Practice Address - Country:US
Practice Address - Phone:914-965-1912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2046941163W00000X
NYF000091176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered176B00000XOther Service ProvidersMidwife