Provider Demographics
NPI:1104365337
Name:KESCHL, PATRICK JOHN (LPN)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOHN
Last Name:KESCHL
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8715 PATHFINDER RD
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1298
Mailing Address - Country:US
Mailing Address - Phone:917-709-3762
Mailing Address - Fax:
Practice Address - Street 1:8715 PATHFINDER RD
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1298
Practice Address - Country:US
Practice Address - Phone:917-709-3762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296980-1164W00000X
PAPN261218L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse