Provider Demographics
NPI:1043761273
Name:KACHNYCZ, GAIL (CRNP)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:KACHNYCZ
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 1:100 WEST SCHOOL HOUSE LANE
Mailing Address - Street 2:PENNSYLVANIA SCHOOL FOR THE DEAF
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144
Mailing Address - Country:US
Mailing Address - Phone:215-951-4719
Mailing Address - Fax:215-951-4704
Practice Address - Street 1:100 W SCHOOL HOUSE LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3404
Practice Address - Country:US
Practice Address - Phone:215-951-4719
Practice Address - Fax:215-951-4704
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001352D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics