=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528682978
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CASSANDRA ARKA LEGAL CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2020
-----------------------------------------------------
Last Update Date | 01/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 551 GREENVILLE RD
-----------------------------------------------------
City | MERCER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16137-5019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-981-0630
-----------------------------------------------------
Fax | 724-347-1156
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 877 LATONKA DR
-----------------------------------------------------
City | MERCER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16137-9740
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-992-2379
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP022031
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------