1952565012 NPI number — DR. JUDITH KAECHELE FNP

Table of content: VIVIANNE JAKOBS RN,MSN,IBCLC, FNP (NPI 1366761322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952565012 NPI number — DR. JUDITH KAECHELE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAECHELE
Provider First Name:
JUDITH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEINDLING
Provider Other First Name:
JUDITH
Provider Other Middle Name:
KAECHELE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DNP, FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952565012
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1290 SILAS DEANE HIGHWAY
Provider Second Line Business Mailing Address:
HHC - CVO
Provider Business Mailing Address City Name:
WETHERSFIELD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06109-4337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 LAFAYETTE ST RM 119
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06604-7719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-576-4712
Provider Business Practice Location Address Fax Number:
203-576-5715
Provider Enumeration Date:
07/17/2008

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:  RN2278378 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 001999 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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