Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | SP008641 | PA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | SP009098 | PA |
NPI | 1033272414 |
---|---|
Provider Name | Christine Burghart Cassesse |
First Address | Ford City, PA 16226-1801 |
Second Address | Kittanning, PA 16201-2416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11664255 | CAQH (01) | PA |
Q46971 | (02) | PA |