MEDICARE: CASSANDRA ANN BRODGINSKI CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	MW010865	PA

General Provider Information

NPI Number	:	1295621001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA ANN BRODGINSKI CNM

Provider Business Mailing Address
First Line	:	1201 GRAMPIAN BLVD
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-1900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 HIGH ST STE 1004
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-3102
Country	:	US
Telephone Number	:	570-321-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	02/16/2026

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