Provider Demographics
NPI:1457709552
Name:FELDENZER, KAITLIN L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:L
Last Name:FELDENZER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:KAITLIN
Other - Middle Name:L
Other - Last Name:DARKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, OCN, CHPN
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-5120
Mailing Address - Fax:717-741-3075
Practice Address - Street 1:2350 FREEDOM WAY STE 200
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8200
Practice Address - Country:US
Practice Address - Phone:717-812-5120
Practice Address - Fax:717-741-3075
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA637937163W00000X
PASP018955363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103511661Medicaid