Healthcare Provider Details

I. General information

NPI: 1346600848
Provider Name (Legal Business Name): CARA NEALON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2016
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 PARK DR STE 101
HARRISBURG PA
17110-9303
US

IV. Provider business mailing address

1600 LEHIGH PKWY E APT 3H
ALLENTOWN PA
18103-3083
US

V. Phone/Fax

Practice location:
  • Phone: 717-686-9842
  • Fax: 844-803-8108
Mailing address:
  • Phone: 608-772-0865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN637111
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP019629
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019629
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: