Individual provider Active NPI

Nancy Lynn Kashlak, RN,CPNP,MSN

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1447463716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
VP000448D Issued in PA
Practice address
1400 S 5TH St
Philadelphia, PA 19147-5919
Phone
(215) 467-3515
NPI assigned
May 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X VP000448D PA Primary

Addresses

Primary practice location

1400 S 5TH St
Philadelphia, PA 19147-5919

Mailing address

77 Mahanoy Ave
Hometown
Tamaqua, PA 18252-4006
Phone (570) 668-3704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
VP000448DPAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447463716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MAHANOY AVE",
            "address_2": "HOMETOWN",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182524006",
            "telephone_number": "570-668-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191475919",
            "telephone_number": "215-467-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHLAK",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "credential": "RN,CPNP,MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "VP000448D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.