Provider Demographics
NPI:1639197791
Name:PACKARD, CHRISTINE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANN
Last Name:PACKARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:336 BRANDON AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3316
Mailing Address - Country:US
Mailing Address - Phone:570-322-4791
Mailing Address - Fax:570-322-5170
Practice Address - Street 1:1705 WARREN AVE STE 304
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-2665
Practice Address - Country:US
Practice Address - Phone:570-322-4791
Practice Address - Fax:570-322-5170
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008515L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry