Provider Demographics
NPI:1295183986
Name:LEISTER, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LEISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:KERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 W PORTLAND ST
Mailing Address - Street 2:APT. 18
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-7417
Mailing Address - Country:US
Mailing Address - Phone:610-639-9905
Mailing Address - Fax:
Practice Address - Street 1:124 W PORTLAND ST
Practice Address - Street 2:APT. 18
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-7417
Practice Address - Country:US
Practice Address - Phone:610-639-9905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist