Healthcare Provider Details

I. General information

NPI: 1396483061
Provider Name (Legal Business Name): CHRISTINE KASTEN BSN, PHN, RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 KAYLA LN
HANOVER MN
55341-4504
US

IV. Provider business mailing address

577 80TH STREET NW
BUFFALO MN
55313
US

V. Phone/Fax

Practice location:
  • Phone: 763-482-1736
  • Fax:
Mailing address:
  • Phone: 763-482-1736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberR1476248
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: