Healthcare Provider Details

I. General information

NPI: 1720413701
Provider Name (Legal Business Name): JAIME MCCAUSLIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 S BEAVER ST
YORK PA
17401-2209
US

IV. Provider business mailing address

5920 HAMILTON BLVD
ALLENTOWN PA
18106-8942
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-9681
  • Fax:
Mailing address:
  • Phone: 610-481-0481
  • Fax: 610-481-0486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013059
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: