Provider Demographics
NPI:1770684086
Name:KANE, LORRAINE (CNM)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-6654
Mailing Address - Country:US
Mailing Address - Phone:802-251-9965
Mailing Address - Fax:
Practice Address - Street 1:28 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6654
Practice Address - Country:US
Practice Address - Phone:802-251-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT1010110205367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN2016Medicaid
NH30343174Medicaid
VTIX0692Medicare PIN