KYLA M GUSTAVSON (NPI# 1609380021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609380021 |
| Entity Type | Individual |
| Full Name | KYLA M GUSTAVSON |
| Credential | CRNP |
| Practice Address |
800 Spruce St Fl 4 Philadelphia PA 19107-6130 |
| Practice Telephone | 2158293474 |
| Practice Fax Number | 2158295456 |
| Mailing Telephone | 2158293474 |
| Mailing Fax Number | 2158295456 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2019-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP020135 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
800 SPRUCE ST FL 4 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-6130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457606402 | Mitali Patnaik | Psychiatry & Neurology | 800 Spruce St Fl 4, Philadelphia, PA 19107-6130 | 2012-07-16 |
| 1841778438 | Emily Michele Becker Haimes | Psychologist | 800 Spruce St Fl 4, Philadelphia, PA 19107 | 2018-08-06 |
| 1184148785 | Christine Peregrim Carpenter | Nurse Practitioner | 800 Spruce St Fl 4, Philadelphia, PA 19107-6130 | 2017-07-26 |
| 1366861817 | Ashley M Un | Psychiatry & Neurology | 800 Spruce St Fl 4, Philadelphia, PA 19107-6130 | 2014-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199341 | Nicole Kassandra Carissimi | Nurse Practitioner | 1618 S 19th St, Philadelphia, PA 19145-1439 | 2020-09-19 |
| 1770192775 | Lisa Ghiloni | Nurse Practitioner | 6809 N 10th St, Philadelphia, PA 19126-2906 | 2020-07-26 |
| 1104440940 | Patricia Cecilia Castillo | Nurse Practitioner | 49204 Delaire Landing Rd, Philadelphia, PA 19114-5329 | 2020-06-06 |
| 1184271074 | Clement John | Nurse Practitioner | 3253 N 6th St, Philadelphia, PA 19140-5644 | 2019-08-25 |
| 1558915967 | Latoya Mohammed | Nurse Practitioner | 3300 Henry Ave Ste 3n, Philadelphia, PA 19129-1141 | 2019-07-25 |
| 1225427867 | Alison Ercole | Nurse Practitioner | 4301 Spruce St, Apt A 414, Philadelphia, PA 19104-4760 | 2015-01-20 |
| 1790195386 | Thomasean Britten | Nurse Practitioner | 449 Parker Ave, Philadelphia, PA 19128-4403 | 2014-05-05 |
| 1891048377 | Elizabeth Ann Milburn | Nurse Practitioner | 1528 Walnut St Ste 1414, Philadelphia, PA 19102-3610 | 2012-10-20 |
| 1336410851 | Justin Egoville | Nurse Practitioner | 80001 State Rd., Mhm Correctional Services, Mod II, Philadelphia, PA 19136-0000 | 2012-01-13 |
| 1396050720 | Dwayne M Toomer | Nurse Practitioner | 718 Addison St Apt E, Philadelphia, PA 19147-1353 | 2010-08-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on KYLA M GUSTAVSON.
| 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.