Provider Demographics
NPI:1942184080
Name:KANG, ABBAS ALI (FNP-C)
Entity type:Individual
Prefix:MR
First Name:ABBAS
Middle Name:ALI
Last Name:KANG
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 KENILWORTH DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-2048
Mailing Address - Country:US
Mailing Address - Phone:517-763-8684
Mailing Address - Fax:
Practice Address - Street 1:1428 KENILWORTH DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-2048
Practice Address - Country:US
Practice Address - Phone:517-763-8684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704365231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily