Healthcare Provider Details
I. General information
NPI: 1174525893
Provider Name (Legal Business Name): JANE DREAS MASON MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1259 S CEDAR CREST BLVD STE 100
ALLENTOWN PA
18103-6373
US
IV. Provider business mailing address
1259 S CEDAR CREST BLVD SUITE 100
ALLENTOWN PA
18103-6372
US
V. Phone/Fax
- Phone: 610-437-4134
- Fax: 610-433-9690
- Phone: 610-437-4134
- Fax: 610-433-9690
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | SP001704C |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | SP001704C |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: