1801341771 NPI number — KAYA LOREE TUCHSCHERER PT

Table of content: KAYA LOREE TUCHSCHERER PT (NPI 1801341771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801341771 NPI number — KAYA LOREE TUCHSCHERER PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TUCHSCHERER
Provider First Name:
KAYA
Provider Middle Name:
LOREE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLS
Provider Other First Name:
KAYA
Provider Other Middle Name:
LOREE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801341771
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8467
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
83002-8467
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-223-6571
Provider Business Mailing Address Fax Number:
307-733-5505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46 IRON HORSE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPINE
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
83128-9101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-654-5577
Provider Business Practice Location Address Fax Number:
307-654-5578
Provider Enumeration Date:
08/22/2016

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: 225100000X , with the licence number:  1635 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 144246500 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com