Provider Demographics
NPI:1841713781
Name:MCKANE, KIMBERLY HELEN (ARNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:HELEN
Last Name:MCKANE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1629
Mailing Address - Country:US
Mailing Address - Phone:603-358-3384
Mailing Address - Fax:603-357-1242
Practice Address - Street 1:91 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1629
Practice Address - Country:US
Practice Address - Phone:603-358-3384
Practice Address - Fax:603-357-1242
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH063353-23363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3151125Medicaid
NH063353-23OtherSTATE