Provider Demographics
NPI:1114393980
Name:CAPALDO, DAWN (CRNP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:CAPALDO
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 1:250 KING OF PRUSSIA RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5235
Mailing Address - Country:US
Mailing Address - Phone:610-902-1500
Mailing Address - Fax:610-902-1544
Practice Address - Street 1:250 KING OF PRUSSIA RD STE 1B
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-5235
Practice Address - Country:US
Practice Address - Phone:610-902-1500
Practice Address - Fax:610-902-1544
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015003363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA445529HGAMedicare UPIN