Healthcare Provider Details

I. General information

NPI: 1083113047
Provider Name (Legal Business Name): KASSANDRA BARTHELEMY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 QUARRY DR STE E58C
WEST LAWN PA
19609-1170
US

IV. Provider business mailing address

5017 PEPPER LN
DOUGLASSVILLE PA
19518-9505
US

V. Phone/Fax

Practice location:
  • Phone: 484-773-1141
  • Fax: 484-214-7768
Mailing address:
  • Phone: 267-431-5305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP018713
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAG01180040
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: