Individual provider · Type 1 NPI
Kimberly Reardon Banigan, CPNP
Pediatric Nurse Practitioner · Boston, MA
NPI number
1306240429
Active
Practice location
300 Longwood Ave
Boston, MA 02115-5724
Fax (617) 730-0621
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209011064 (IL) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | RN2316271 (MA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1306240429
Kimberly Reardon Banigan, CPNP's National Provider Identifier is 1306240429, issued on Oct 17, 2014. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Boston, MA. The record was last updated on Aug 28, 2017.