Healthcare Provider Details

I. General information

NPI: 1194323733
Provider Name (Legal Business Name): CASEY YODER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 B EAST 21ST ST STE 400
NORTHAMPTON PA
18067-1269
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7275
  • Fax: 833-820-1011
Mailing address:
  • Phone: 484-526-6048
  • Fax: 833-213-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP022656
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: