Provider Demographics
NPI:1326036419
Name:PALANK, CHRISTINE LA PORTE (RN, MS, ANP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LA PORTE
Last Name:PALANK
Suffix:
Gender:F
Credentials:RN, MS, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SHEPHERD LN
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-4681
Mailing Address - Country:US
Mailing Address - Phone:304-876-2991
Mailing Address - Fax:304-876-5509
Practice Address - Street 1:SHEPHERD UNIV STUDENT HEALTH SERVICES
Practice Address - Street 2:E KING ST
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-1032
Practice Address - Country:US
Practice Address - Phone:304-876-5161
Practice Address - Fax:304-876-5509
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV29775363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health