Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD466518 | PA |
NPI | 1003182114 |
---|---|
Provider Name | Kaci Elizabeth Christian |
First Address | Lancaster, PA 17601-2644 |
Second Address | Lancaster, PA 17601-2644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2012 |
Last Update Date | 09/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1036159890001 | (05) | PA |
1036159890002 | (05) | PA |
1036159890003 | (05) | PA |
792620 | MEDICARE (01) | PA |
FC8192801 | DEA (01) | PA |
MD466518 | MEDICAL LICENSE (01) | PA |