Provider Demographics
NPI:1720413701
Name:MCCAUSLIN, JAIME (CRNP)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:MCCAUSLIN
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 1:5920 HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-8942
Mailing Address - Country:US
Mailing Address - Phone:610-481-0481
Mailing Address - Fax:610-481-0486
Practice Address - Street 1:728 S BEAVER ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-2209
Practice Address - Country:US
Practice Address - Phone:717-845-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily