Healthcare Provider Details
I. General information
NPI: 1528050317
Provider Name (Legal Business Name): CHRISTA A HOFFEDITZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/17/2005
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12 ST PAUL DR STE 204
CHAMBERSBURG PA
17201-1035
US
IV. Provider business mailing address
785 5TH AVE STE 3
CHAMBERSBURG PA
17201-4232
US
V. Phone/Fax
- Phone: 717-217-6886
- Fax: 717-217-6896
- Phone: 717-263-9555
- Fax: 717-709-6529
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | SP008212 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | SP008212 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: