Provider Demographics
NPI:1386631224
Name:SILVA, CHARLENE E (CRNA)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:E
Last Name:SILVA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN306821L163W00000X
PA048903367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1344353OtherFIRST PRIORITY
PA1344353OtherHIGHMARK
PA1027798890001Medicaid
PA1344353OtherKHP CENTRAL
PA82869OtherGEISINGER
PA03225501OtherCAPITAL ADVANTAGE
PA11783708OtherCAQH
PA9512458OtherAETNA
PA1543864OtherGATEWAY
PA2036930000OtherINDEP. BLUE CROSS
PA2036930000OtherINDEP. BLUE CROSS
PA03225501OtherCAPITAL ADVANTAGE
PAS48791Medicare UPIN