Jacqueline Kobal, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP012774 Issued in PA

Practice address

1100 Meade St
Dunmore, PA 18512-3169

Phone

(570) 342-3675

Fax

(570) 342-3316

NPI assigned

Feb 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1710227137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MEADE ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123169",
            "telephone_number": "570-342-3675",
            "fax_number": "570-342-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MEADE ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123169",
            "telephone_number": "570-342-3675",
            "fax_number": "570-342-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBAL",
        "first_name": "JACQUELINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF PENNSYLVANIA",
            "identifier": "SP012774",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keystone Medical Laboratories, L.P.
• Lori A. Kishel
• Kelly A Klee-Medici
• Mary Byrne Klem, MS RD LDN
• Dana E. Klush, DPM
• George A. Kofel, R.PH.
• Karissa Nicole Kopf, PA-C
• Steven Kravitz, PA
• Amy L Kreckman, MSW, LSW
• Emily Kuchwara, MS, LAPC, NCC, CADC

• Adult Health Nurse Practitioner in Dunmore, PA
• Providers in Dunmore, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.