Provider Demographics
NPI:1083754832
Name:MCILHANEY, CHRISTINA CARROLL (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:CARROLL
Last Name:MCILHANEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 VALLEY CENTER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2267
Mailing Address - Country:US
Mailing Address - Phone:610-954-2778
Mailing Address - Fax:
Practice Address - Street 1:1510 VALLEY CENTER PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2267
Practice Address - Country:US
Practice Address - Phone:610-954-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN260977L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016046540001Medicaid