Demetria Bazemore-Anderson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP030773 Issued in PA

Practice address

374 Mountain Blvd
Wernersville, PA 19565-9219

Phone

(570) 561-2982

Fax

(570) 300-1829

NPI assigned

Nov 13, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1750105128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 MOUNTAIN BLVD",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "195659219",
            "telephone_number": "570-561-2982",
            "fax_number": "570-300-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 MOUNTAIN BLVD",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "195659219",
            "telephone_number": "570-561-2982",
            "fax_number": "570-300-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEMORE-ANDERSON",
        "first_name": "DEMETRIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP030773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillerma Abeleda, M.D.
• Diana Abreu
• Aj Giesa DMD LLC
• Sarah Alley, MA
• Jenell August, CRNP
• Berks Family Eyecare P C
• Berks Family Eyecare P C
• Irene Biondo
• Harry Norman Blumner III, PSD
• Donna Boulanger, MS, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Wernersville, PA
• Providers in Wernersville, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.