Healthcare Provider Details

I. General information

NPI: 1891999124
Provider Name (Legal Business Name): KYNA CASTANEDA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 S CEDAR CREST BLVD STE 201
ALLENTOWN PA
18103-6258
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-4870
  • Fax: 610-433-8791
Mailing address:
  • Phone: 215-710-5522
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010158
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberTP002230G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: