Healthcare Provider Details

I. General information

NPI: 1548737505
Provider Name (Legal Business Name): THERESA CLEARY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 S WEST END BLVD
QUAKERTOWN PA
18951-1140
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 215-538-4930
  • Fax: 215-538-4931
Mailing address:
  • Phone: 484-526-8046
  • Fax: 833-213-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP019437
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: