Provider Demographics
NPI:1952606584
Name:CASTANEDA, KRISTINA MARIA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:MARIA
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:KRISTINA
Other - Middle Name:MARIA
Other - Last Name:HATLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:451 BETTY LN
Mailing Address - Street 2:
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-2906
Mailing Address - Country:US
Mailing Address - Phone:651-602-0216
Mailing Address - Fax:
Practice Address - Street 1:451 BETTY LN
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-2906
Practice Address - Country:US
Practice Address - Phone:651-602-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN86610367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered