KAYCE KRUCKI (NPI# 1538670062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538670062 |
| Entity Type | Individual |
| Full Name | KAYCE KRUCKI |
| Credential | LAT, ATC |
| Practice Address |
275 Eastland Rd Berea OH 44017-2005 |
| Practice Telephone | 4408262221 |
| Mailing Telephone | 4408262221 |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
005374 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 N Main St, Findlay, OH 458403653 | 4194346940 |
| Street Address |
275 EASTLAND RD |
| City | BEREA |
| State | OH |
| Zip Code | 44017-2005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669401006 | Andrea Monique Cook | Specialist/Technologist | 275 Eastland Rd, Berea, OH 44017-2005 | 2006-06-30 |
| 1881208692 | Molly Sephel | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-31 |
| 1821601493 | Andrea N Mcgannon | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-25 |
| 1093327983 | Mariah Cluss | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-20 |
| 1457963472 | Rylee Morgan Wheaton | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-20 |
| 1427660539 | Emily Po | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-19 |
| 1538779046 | Makenzie Karissa Mansfield Bowers | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-10 |
| 1053936740 | Mackenzie Nicole Winkle | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-06-09 |
| 1720602105 | Vincent Evanoff | Physician Assistant | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-06-02 |
| 1811510761 | Olivia Nicole Lust | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632759 | Faseeha Raza | Student in an Organized Health Care Education/Training Program | Baldwin Wallace University Physician Assistant Program, 201 Front Street, Berea, OH 44017 | 2020-05-28 |
| 1851885412 | Monica Lynne Mcfarland | Occupational Therapy Assistant | 570 North Rocky River Drive, Berea, OH 44017 | 2018-06-18 |
| 1700301207 | Cherelle Scott | Counselor | 398 W Bagley Road Ste, Suite 216, Berea, OH 44017 | 2017-08-07 |
| 1780042457 | Linda Lou Cummings | Social Worker | 202 E. Bagley Road, Berea, OH 44017 | 2016-02-09 |
| 1760827042 | Pathways Hospice LLC | Hospice Care, Community Based | 885 W. Bagley Road, Berea, OH 44017 | 2013-05-01 |
| 1336457134 | Mary Elizabeth Italiano-burke | Licensed Practical Nurse | 90 Emerson Dr., #11009, Berea, OH 44017 | 2010-09-15 |
| 1720260979 | Cooperative Medical Health Care Corporation Professional Association | Mechanotherapist | 165 W. Bagley Rd., Berea, OH 44017 | 2007-11-29 |
| 1326230616 | Marilyn Sue George | Psychoanalyst | 187 Seminary St, Berea, OH 44017 | 2007-08-10 |
| 1437371556 | Michael Charles Powell | Registered Nurse | 501 Nobottom Rd, Berea, OH 44017 | 2007-05-02 |
| 1538381439 | Paula Davis Fultz | Counselor | 303 E. Bagley Road, Berea, OH 44017 | 2007-05-02 |
| Find all providers in zip 44017 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578175519 | Danielle Renee Walker | Student in an Organized Health Care Education/Training Program | Physician Assistant Program, 275 Eastland Rd, Berea, OH 44017-2088 | 2020-08-20 |
| 1144844382 | Bethany Hockensmith | Student in an Organized Health Care Education/Training Program | 236 Creekwood Dr, Berea, KY 40403-8706 | 2020-06-03 |
| 1023632759 | Faseeha Raza | Student in an Organized Health Care Education/Training Program | Baldwin Wallace University Physician Assistant Program, 201 Front Street, Berea, OH 44017 | 2020-05-28 |
| 1992173942 | Megan Williams | Student in an Organized Health Care Education/Training Program | 472 Edgewood Cir, Berea, OH 44017-2428 | 2015-09-08 |
| 1881208692 | Molly Sephel | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-31 |
| 1821601493 | Andrea N Mcgannon | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-25 |
| 1649883307 | Kallie Lin Hinspeter | Student in an Organized Health Care Education/Training Program | 201 Front St, Berea, OH 44017-1998 | 2020-08-24 |
| 1093327983 | Mariah Cluss | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-20 |
| 1457963472 | Rylee Morgan Wheaton | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-20 |
| 1427660539 | Emily Po | Student in an Organized Health Care Education/Training Program | 275 Eastland Rd, Berea, OH 44017-2005 | 2020-08-19 |
| Find all providers in BEREA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.