Basic Information
Provider Information
NPI: 1205074275
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CZAPLEWSKI
FirstName: KAY
MiddleName: M
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2699
Address2:  
City: PENSACOLA
State: FL
PostalCode: 325132699
CountryCode: US
TelephoneNumber: 8504166933
FaxNumber: 8504166934
Practice Location
Address1: 1545 AIRPORT BLVD
Address2: SUITE 2000
City: PENSACOLA
State: FL
PostalCode: 325048615
CountryCode: US
TelephoneNumber: 8504166933
FaxNumber: 8504166934
Other Information
ProviderEnumerationDate: 01/29/2009
LastUpdateDate: 05/05/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XARNP9252985FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

ID Information
IDTypeStateIssuerDescription
120507427505WI MEDICAID


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