Provider Demographics
NPI:1407284854
Name:ANDERSON, CASEY LEIGH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:LEIGH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:CASEY
Other - Middle Name:LEIGH
Other - Last Name:HOFERICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-1306
Mailing Address - Country:US
Mailing Address - Phone:610-328-8058
Mailing Address - Fax:
Practice Address - Street 1:500 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-1306
Practice Address - Country:US
Practice Address - Phone:610-328-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015259363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care