Provider Demographics
NPI:1164603932
Name:GEHMAN, CHRISTIE A (LDN)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:A
Last Name:GEHMAN
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 W NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9491
Mailing Address - Country:US
Mailing Address - Phone:717-735-7913
Mailing Address - Fax:717-723-4375
Practice Address - Street 1:6 W NEWPORT RD
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7774
Practice Address - Country:US
Practice Address - Phone:717-735-7913
Practice Address - Fax:717-723-4375
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001782133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA940973Medicare PIN