Healthcare Provider Details

I. General information

NPI: 1962954784
Provider Name (Legal Business Name): CHRISTINE M BUCKLEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE M GITTINGS CRNP

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 01/23/2021
Certification Date: 01/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 FISHER RD
MECHANICSBURG PA
17055-5122
US

IV. Provider business mailing address

2140 FISHER RD
MECHANICSBURG PA
17055-5122
US

V. Phone/Fax

Practice location:
  • Phone: 717-766-1975
  • Fax: 717-697-6575
Mailing address:
  • Phone: 717-766-1795
  • Fax: 717-697-6575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016201
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: