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Individual

KIRSTYN SHEA CASSIDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
5105 WOODMONT CIR, MACUNGIE, PA 18062-8590
(757) 660-7892
Mailing address
5105 WOODMONT CIR, MACUNGIE, PA 18062-8590
(757) 660-7892

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN691716
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN691716
RN LICENSE
PA
Enumeration date
07/11/2018
Last updated
07/11/2018
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