Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP008844 | PA |
NPI | 1295856664 |
---|---|
Provider Name | Christa Nishnick |
First Address | North East, PA 16428-3867 |
Second Address | Erie, PA 16550-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |