Provider Demographics
NPI:1497202931
Name:TARBELL, KAILEY E (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAILEY
Middle Name:E
Last Name:TARBELL
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 1:300 STATE ST STE 401
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1438
Mailing Address - Country:US
Mailing Address - Phone:814-877-5333
Mailing Address - Fax:814-877-5329
Practice Address - Street 1:300 STATE ST STE 401
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1438
Practice Address - Country:US
Practice Address - Phone:814-877-5333
Practice Address - Fax:814-877-5329
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016533363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner