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1043865512 NPI number — KAYLA MARIE SCHRECKENGOST NP-C

NPI Number: 1043865512
Health Care Provider/Practitioner: KAYLA MARIE SCHRECKENGOST NP-C

Information about “1043865512” NPI (KAYLA MARIE SCHRECKENGOST NP-C) exists in 1043865512 in HTML format HTML  |  1043865512 in plain Text format TXT  |  1043865512 in PDF (Portable Document Format) PDF  |  1043865512 in an XML format XML  formats.

NPI Number : 1043865512 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1043865512",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SCHRECKENGOST",
    "FirstName": "KAYLA",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1919 LEASURE RUN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROCHESTER MILLS",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "15771-7523",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "814-952-2841",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "700 LEONARD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLEARFIELD",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "16830-3245",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "814-765-7545",
    "PracticeLocationAddressFaxNumber": "814-765-9745",
    "EnumerationDate": "08/01/2019",
    "LastUpdateDate": "08/01/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LG0600X",
        "TaxonomyName": "Gerontology Nurse Practitioner",
        "LicenseNumber": "SP020370",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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