Provider Demographics
NPI:1740843531
Name:KUGLER, XENIA I (RN)
Entity type:Individual
Prefix:
First Name:XENIA
Middle Name:I
Last Name:KUGLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:XENIA
Other - Middle Name:IRIS
Other - Last Name:KEDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 MEDICAL PARK LN
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-9112
Mailing Address - Country:US
Mailing Address - Phone:814-355-7322
Mailing Address - Fax:814-355-9604
Practice Address - Street 1:141 MEDICAL PARK LN
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-9112
Practice Address - Country:US
Practice Address - Phone:814-355-7322
Practice Address - Fax:814-355-9604
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020767363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology