Individual
MRS. JOAN ELYSE BACKENSTOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3147 COLLEGE HEIGHTS BLVD, ALLENTOWN, PA 18104-4813
(610) 841-2432
(610) 841-4433
Mailing address
4653 STEVEN LN, WALNUTPORT, PA 18088-9619
(610) 767-3476
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN184932L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016767680004
—
PA
01
—
1466649
HIGHMARK
PA
01
—
20035314
AMERIHEALTH MERCY
PA
01
—
P00456743
RAILROAD MEDICARE
PA
Enumeration date
09/09/2005
Last updated
04/11/2008
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