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General NPI Number Information
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NPI Number | 1366749418
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Entity Type | Individual
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Provider Name | CHRISTINA DAVIDYOCK CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 09/27/2014
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER BLVD
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City | UPLAND
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State | PA
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Zip | 19013
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Country | US
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Telephone | 610-876-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER BLVD SUITE 324
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City | CHESTER
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State | PA
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Zip | 19013-3902
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Country | US
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Telephone | 610-876-0347
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP011128
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License Number State | PA
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