Provider Demographics
NPI:1093450884
Name:GALCZYNSKI, CHRISTA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:MARIE
Last Name:GALCZYNSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:
Other - Last Name:BREIDENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:105 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VALLEY VIEW
Practice Address - State:PA
Practice Address - Zip Code:17983-9423
Practice Address - Country:US
Practice Address - Phone:570-682-8026
Practice Address - Fax:570-682-8043
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025682363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily