1336617687 NPI number — ABIGAIL KIENZLE SCHULTZ FNP-BC

Table of content: ABIGAIL KIENZLE SCHULTZ FNP-BC (NPI 1336617687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336617687 NPI number — ABIGAIL KIENZLE SCHULTZ FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULTZ
Provider First Name:
ABIGAIL
Provider Middle Name:
KIENZLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KIENZLE
Provider Other First Name:
ABIGAIL
Provider Other Middle Name:
HALL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336617687
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1815 JOHN F KENNEDY BLVD APT 2809
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19103-1724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-405-2460
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1218 E LANCASTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYN MAWR
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19010-2616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-389-2727
Provider Business Practice Location Address Fax Number:
401-216-3854
Provider Enumeration Date:
11/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP018951 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com