1417225640 NPI number — MARY KATHRYN REEVES-HOCHE PHD, CRNP, ANP-BC

Table of content: MARY KATHRYN REEVES-HOCHE PHD, CRNP, ANP-BC (NPI 1417225640)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417225640 NPI number — MARY KATHRYN REEVES-HOCHE PHD, CRNP, ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REEVES-HOCHE
Provider First Name:
MARY KATHRYN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD, CRNP, ANP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417225640
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 447
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUCK HILLS FALLS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18323-0447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-957-5023
Provider Business Mailing Address Fax Number:
570-957-4617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 DISCOVERY DRIVE
Provider Second Line Business Practice Location Address:
860, ROOM 339
Provider Business Practice Location Address City Name:
SWIFTWATER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19323-0187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-957-5023
Provider Business Practice Location Address Fax Number:
570-957-4617
Provider Enumeration Date:
12/02/2011

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: 363LA2200X , with the licence number:  SP011454 , 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)





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