Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | TP003996U | PA |
NPI | 1023126471 |
---|---|
Provider Name | Ms. Christine Katharine Faust |
First Address | Bala Cynwyd, PA 19004-1843 |
Second Address | Philadelphia, PA 19104-4551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2006 |
Last Update Date | 08/07/2007 |