Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kag Professional Nurse Practitioner in Adult Health PLLC

Organization Adult Health Nurse Practitioner · NPI 1295391985

Kag Professional Nurse Practitioner in Adult Health PLLC is an Adult Health Nurse Practitioner in Medford, New York. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3115 Horseblock Rd
Medford, NY 11763-2526
Phone: (631) 872-2995
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X

Record details

NPI number1295391985
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelly Godberson — Nurse Practitioner · (631) 872-2995
NPI enumeratedMay 17, 2019
Last updated in NPPESOctober 24, 2022
Certification dateJuly 14, 2022
Mailing address32 Marlin Rd, Centereach, NY 11720-3012

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