Provider Demographics
NPI:1144764218
Name:EBY, KRISTINA BETH (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:BETH
Last Name:EBY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:BETH
Other - Last Name:HERSHEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:717-544-7157
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:717-544-7157
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN584140367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered