Kristyn Valentine Hydock

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP021536 Issued in PA

Practice address

256 Iven Ave Apt 3a
Wayne, PA 19087-4921

Phone

(203) 947-0394

NPI assigned

Feb 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1427681824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 IVEN AVE APT 3A",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190874921",
            "telephone_number": "203-947-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 IVEN AVE APT 3A",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190874921",
            "telephone_number": "203-947-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDOCK",
        "first_name": "KRISTYN",
        "middle_name": "VALENTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP021536",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021536",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP021536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Horning, RDN, LDN
• Clark D Hung, DMD
• Ethan Lillard Hunt, PT
• Roseanita Schubert Hurley, SLP-CCC
• Jessica Hurtubise, OT
• Alison Louise Iacobucci, PT, DPT
• Danielle Illfelder, PT, DPT, MSPT
• Im Physical Medicine
• Imhealth LLC
• Indian Valley Healthcare LLC

• Nurse Practitioner in Wayne, PA
• Providers in Wayne, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.