Provider Demographics
NPI:1508218546
Name:DELACY, CASEY
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:DELACY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-2008
Mailing Address - Country:US
Mailing Address - Phone:610-952-6882
Mailing Address - Fax:
Practice Address - Street 1:2507 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4841
Practice Address - Country:US
Practice Address - Phone:267-512-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016219363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care