Provider Demographics
NPI:1508210709
Name:KAAN, NATHANIEL A (MD)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:A
Last Name:KAAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 RAWLINS ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1800
Mailing Address - Country:US
Mailing Address - Phone:307-323-2679
Mailing Address - Fax:307-323-2740
Practice Address - Street 1:4003 RAWLINS ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1800
Practice Address - Country:US
Practice Address - Phone:307-323-2679
Practice Address - Fax:307-323-2740
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15275A208600000X
WYTL7465208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery