Provider Demographics
NPI:1184296121
Name:CACHO, WANDA F (FNP-BC MSN RN)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:F
Last Name:CACHO
Suffix:
Gender:F
Credentials:FNP-BC MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-3904
Mailing Address - Country:US
Mailing Address - Phone:484-294-1146
Mailing Address - Fax:
Practice Address - Street 1:2536 GARDEN CT
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-3904
Practice Address - Country:US
Practice Address - Phone:484-294-1146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN611196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily