Provider Demographics
NPI:1174773857
Name:CASTANEDA, KAYLA ELISA (RN, WHNP-BC, AOCNP)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ELISA
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:RN, WHNP-BC, AOCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RIM RD SUITE 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902
Mailing Address - Country:US
Mailing Address - Phone:718-240-5978
Mailing Address - Fax:718-240-6610
Practice Address - Street 1:101 RIM RD STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3668
Practice Address - Country:US
Practice Address - Phone:718-240-5978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF370046363L00000X, 363L00000X
NYF421194363LW0102X, 363LW0102X
TXAP117032363LW0102X
TX702729363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204274901Medicaid
TX702729OtherTEXAS BNE ADVANCED PRACTICE LICENSE
NYF421194OtherNEW YORK LICENSE
IL104337808OtherNCC NUMBER
NYF421194OtherNEW YORK LICENSE