Provider Demographics
NPI:1831994623
Name:SANGER, KIRK (RN, PHD)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:SANGER
Suffix:
Gender:M
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-9710
Mailing Address - Country:US
Mailing Address - Phone:857-636-8044
Mailing Address - Fax:
Practice Address - Street 1:229 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03435-0001
Practice Address - Country:US
Practice Address - Phone:603-358-2649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2290805163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse