Healthcare Provider Details

I. General information

NPI: 1194885541
Provider Name (Legal Business Name): KRISTA MARIE RAGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTA FREEMAN

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 POWDER MILL RD
YORK PA
17402-4723
US

IV. Provider business mailing address

1855 POWDER MILL RD
YORK PA
17402-4723
US

V. Phone/Fax

Practice location:
  • Phone: 717-848-4800
  • Fax: 717-747-2966
Mailing address:
  • Phone: 717-848-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC0003085
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA056356
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: