MEDICARE: CARRIE ANN LINGLE CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN695767	PA
2	363LF0000X	Family Nurse Practitioner	SP022855	PA

General Provider Information

NPI Number	:	1710530324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE ANN LINGLE CRNP

Provider Business Mailing Address
First Line	:	2005 TECHNOLOGY PKWY STE 400
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-9413
Country	:	US
Telephone Number	:	717-791-2540
Fax Number	:	717-791-2549

Provider Business Practice Location Address
First Line	:	810 SIR THOMAS CT STE 101
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-4839
Country	:	US
Telephone Number	:	717-614-4420
Fax Number	:	717-614-4421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2019
Last Update Date	:	05/22/2026

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