Provider Demographics
NPI:1033272414
Name:CASSESSE, CHRISTINE BURGHART (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:BURGHART
Last Name:CASSESSE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 NEALE AVE
Mailing Address - Street 2:
Mailing Address - City:FORD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16226-1801
Mailing Address - Country:US
Mailing Address - Phone:724-763-7998
Mailing Address - Fax:
Practice Address - Street 1:300 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2416
Practice Address - Country:US
Practice Address - Phone:724-543-2941
Practice Address - Fax:724-548-8119
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009098363LP0808X
PASP008641363LF0000X
PARN204150L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11664255OtherCAQH
PA092371D5QMedicare ID - Type Unspecified
PA11664255OtherCAQH