Provider Demographics
NPI:1437556628
Name:CALDWELL, KRISTEN (CRNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5612 EASTON RD.
Mailing Address - Street 2:PO BOX 866
Mailing Address - City:PLUMSTEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18949-0866
Mailing Address - Country:US
Mailing Address - Phone:215-766-8844
Mailing Address - Fax:215-766-0733
Practice Address - Street 1:5612 EASTON RD.
Practice Address - Street 2:
Practice Address - City:PLUMSTEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:18949-0866
Practice Address - Country:US
Practice Address - Phone:215-766-8844
Practice Address - Fax:215-766-0733
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014604363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health