Provider Demographics
NPI:1043865512
Name:SCHRECKENGOST, KAYLA MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:SCHRECKENGOST
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 LEASURE RUN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15771-7523
Mailing Address - Country:US
Mailing Address - Phone:814-952-2841
Mailing Address - Fax:
Practice Address - Street 1:700 LEONARD ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3245
Practice Address - Country:US
Practice Address - Phone:814-765-7545
Practice Address - Fax:814-765-9745
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020370363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology