Provider Demographics
NPI:1093146540
Name:HOLTZ, CHRISTINE D (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:D
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3489 SMOKETOWN RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-8317
Mailing Address - Country:US
Mailing Address - Phone:717-465-5437
Mailing Address - Fax:
Practice Address - Street 1:2030 THISTLE HILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-1159
Practice Address - Country:US
Practice Address - Phone:717-225-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013518363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health