Provider Demographics
NPI:1477650448
Name:LUDWICK, CHRISTINE LYNN (PAC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNN
Last Name:LUDWICK
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:LYNN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:161 OLD SCHOOLHOUSE LN
Mailing Address - Street 2:STE 3
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5684
Mailing Address - Country:US
Mailing Address - Phone:717-691-7100
Mailing Address - Fax:717-691-6855
Practice Address - Street 1:49 PRINCE ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-3113
Practice Address - Country:US
Practice Address - Phone:717-901-3440
Practice Address - Fax:717-901-3447
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051940363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA051940OtherPA MEDICAL LICENSE
MW1257028OtherDEA
MW1257028OtherDEA