Individual provider Active NPI

Katie Lynn Kirclich, CRNP

  • Nurse Practitioner
  • Meadville, PA
National Provider Identifier
1407602758
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP030407 Issued in PA
Practice address
766 Liberty St
Meadville, PA 16335-2555
Phone
(814) 333-5403
Fax
(814) 333-5407
NPI assigned
Apr 27, 2024
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP030407 PA Primary
Registered Nurse 163W00000X RN-611318 PA

Addresses

Primary practice location

766 Liberty St
Meadville, PA 16335-2555

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5403

Other practice location 1

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000 ext. 2131

Other practice location 2

29585 Lee Rd
Waterford, PA 16441-3009
Phone (814) 602-3684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250508003614 PA Practitioner - Nurse Practitioner 1658898077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

766 Liberty St
Meadville, PA 16335-2555
Phone (814) 333-5403

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN-611318PAMDRegistered Nurse
SP030407PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Crawford County, Inc. CurrentSince Mar 7, 2025 Accepting new patients
Hospice of Crawford County Inc CurrentSince Mar 7, 2025 Accepting new patients

Locations

766 Liberty St
Meadville, PA 16335
Phone (814) 333-5403

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1407602758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5403",
            "fax_number": "814-333-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352555",
            "telephone_number": "814-333-5403",
            "fax_number": "814-333-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165500002",
            "country_code": "US",
            "telephone_number": "814-877-6000 x2131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29585 Lee Rd",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "PA",
            "postal_code": "164413009",
            "country_code": "US",
            "telephone_number": "814-602-3684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRCLICH",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-27",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP030407",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN-611318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.