1396920492 NPI number — MRS. NINA R KIRCHGESSNER ARNP, PMHNP-BC

Table of content: MRS. NINA R KIRCHGESSNER ARNP, PMHNP-BC (NPI 1396920492)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396920492 NPI number — MRS. NINA R KIRCHGESSNER ARNP, PMHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRCHGESSNER
Provider First Name:
NINA
Provider Middle Name:
R
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP, PMHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CUTTLER
Provider Other First Name:
NINA
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396920492
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1790 E VENICE AVE STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VENICE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34292-3191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-488-8884
Provider Business Mailing Address Fax Number:
941-488-5554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1790 E VENICE AVE STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VENICE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34292-3191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-488-8884
Provider Business Practice Location Address Fax Number:
941-488-5554
Provider Enumeration Date:
01/08/2008

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: 363L00000X , with the licence number:  1973 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 1973 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 1973 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: ARNP9293213 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6113067 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 254492 . This is a "COMPSYCH" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: AA30158552 . This is a "MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 2275621 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 9531492 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: NP1255 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 212977 . This is a "MEDCOST" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 600657-204 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: PENDING , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100129030 . This is a "APS HEALTHCARE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 002276700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com