Healthcare Provider Details

I. General information

NPI: 1326016734
Provider Name (Legal Business Name): JUANITA KANESS CRNP,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 OSTRUM ST STE 303
FOUNTAIN HILL PA
18015-1152
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-3900
  • Fax:
Mailing address:
  • Phone: 484-526-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberTP001455G
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN247248L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: