ZACHARY AUSTIN KIETZMAN NP-C NPI 1861012015

NPI Information

NPI: 1861012015
Provider Name: ZACHARY AUSTIN KIETZMAN, NP-C
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
3 FARM GLEN BLVD
FARMINGTON, CT
ZIP 06030
Phone: (803) 629-4134
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Zachary Austin Kietzman, NP-C is a primary care nurse practitioner in Farmington, CT. Zachary Austin Kietzman, NP-C NPI is 1861012015. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3 FARM GLEN BLVD
FARMINGTON, CT
ZIP 06030-285
Phone: (803) 629-4134

The NPI 1861012015 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/17/2020 and was last updated on 8/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		209707	CONNECTICUT	No
2	363LG0600X	Nurse Practitioner	Gerontology	RN236642	GEORGIA	No
3	163W00000X	Registered Nurse		RN236642	GEORGIA	No
4	363LG0600X	Nurse Practitioner	Gerontology	12068	CONNECTICUT	No
5	363LP2300X	Nurse Practitioner	Primary Care	RN236642	GEORGIA	No
6	363LP2300X	Nurse Practitioner	Primary Care	12068	CONNECTICUT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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