Provider Demographics
NPI:1447038344
Name:FOCHT, KERRSTIN DAWN (CRNP)
Entity type:Individual
Prefix:
First Name:KERRSTIN
Middle Name:DAWN
Last Name:FOCHT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 COVE LANE RD
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-8323
Mailing Address - Country:US
Mailing Address - Phone:814-889-8419
Mailing Address - Fax:
Practice Address - Street 1:105 NASON DR
Practice Address - Street 2:
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-1202
Practice Address - Country:US
Practice Address - Phone:814-224-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily