Provider Demographics
NPI:1952565012
Name:KAECHELE, JUDITH (FNP)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:KAECHELE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:KAECHELE
Other - Last Name:WEINDLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP
Mailing Address - Street 1:1290 SILAS DEANE HIGHWAY
Mailing Address - Street 2:HHC - CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 LAFAYETTE ST RM 119
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-7719
Practice Address - Country:US
Practice Address - Phone:203-576-4712
Practice Address - Fax:203-576-5715
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278378363L00000X
CT001999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner