Provider Demographics
NPI:1679013056
Name:VLCEK, CHRISTINE (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:VLCEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:423 N 21ST ST
Practice Address - Street 2:STE 100
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2207
Practice Address - Country:US
Practice Address - Phone:717-761-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN583109163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology