Basic Information
| Provider Information | |||||||||
| NPI: | 1851474886 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCANS | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 858 | ||||||||
| Address2: | MC A410 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170330858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
| FaxNumber: | 7175314587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 02/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD469591 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 2080P0204X | MD050507L | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 2080P0204X | MA64177 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 207PP0204X | MD050507L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0707002000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 2118050 | 01 | NJ | UNITED HEALTHCARE | OTHER | 3500503 | 01 | NJ | AETNA | OTHER | P3549980 | 01 | NJ | OXFORD | OTHER | 6737244 | 01 | NJ | CIGNA | OTHER | 763187 | 01 | NJ | AMERIHEALTH PPO/PA BS | OTHER | 18994 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 60005649 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 010006264 00 | 01 | NJ | AMERICHOICE | OTHER | 7046600 | 05 | NJ | MEDICAID |