Healthcare Provider Details

I. General information

NPI: 1649129735
Provider Name (Legal Business Name): GODIVA KAMWANYA BIAYI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 INNOVATION DR
YORK PA
17408-8815
US

IV. Provider business mailing address

1701 INNOVATION DR
YORK PA
17408-8815
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-8623
  • Fax: 717-862-5576
Mailing address:
  • Phone: 717-843-8623
  • Fax: 717-862-5576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP034893
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP034893
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP034893
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: