Provider Demographics
NPI:1437108198
Name:MINTHORN, CRISTA NEL (RN,C, ANP, APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:CRISTA
Middle Name:NEL
Last Name:MINTHORN
Suffix:
Gender:F
Credentials:RN,C, ANP, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 EDGEWOOD ROAD
Mailing Address - Street 2:BOX 202
Mailing Address - City:RIEGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18077
Mailing Address - Country:US
Mailing Address - Phone:610-749-0541
Mailing Address - Fax:
Practice Address - Street 1:737 EDGEWOOD RD
Practice Address - Street 2:BOX 202
Practice Address - City:RIEGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18077
Practice Address - Country:US
Practice Address - Phone:610-749-0541
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004424C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health