Healthcare Provider Details

I. General information

NPI: 1386274355
Provider Name (Legal Business Name): BRISTEENA K PETER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2020
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 HARRISBURG PIKE STE 310
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

122 BROADSTONE ST
LANCASTER PA
17603-9036
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3232
  • Fax:
Mailing address:
  • Phone: 717-538-9208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP021747
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: