Healthcare Provider Details

I. General information

NPI: 1497427090
Provider Name (Legal Business Name): KEARSTIN KAYE WYLAND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 PIKE ST
HUNTINGDON PA
16652-1172
US

IV. Provider business mailing address

260 WERTZ DR
TYRONE PA
16686-7738
US

V. Phone/Fax

Practice location:
  • Phone: 814-643-6520
  • Fax:
Mailing address:
  • Phone: 814-327-8620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP024347
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP030990
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: