Provider Demographics
NPI:1114789344
Name:CACCHIO, ERIN (CRNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CACCHIO
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 1:4201 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-5409
Mailing Address - Country:US
Mailing Address - Phone:215-951-2986
Mailing Address - Fax:215-951-6867
Practice Address - Street 1:4201 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-5409
Practice Address - Country:US
Practice Address - Phone:215-951-2986
Practice Address - Fax:215-951-6867
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily