Healthcare Provider Details

I. General information

NPI: 1336717610
Provider Name (Legal Business Name): CAYLOR JOHNSON CALLAGHAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD
WEST CHESTER PA
19380-4269
US

IV. Provider business mailing address

115 CRESTVIEW DR
KENNETT SQUARE PA
19348-2251
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-3122
  • Fax:
Mailing address:
  • Phone: 610-608-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP023874
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: