Healthcare Provider Details

I. General information

NPI: 1679563175
Provider Name (Legal Business Name): CASSANDRA ELIZABETH CAMPBELL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N 6TH ST
READING PA
19601-3096
US

IV. Provider business mailing address

2494 BERNVILLE RD STE G02
READING PA
19605-9466
US

V. Phone/Fax

Practice location:
  • Phone: 610-208-4543
  • Fax:
Mailing address:
  • Phone: 610-378-2317
  • Fax: 610-208-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP017265
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberR55819
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: