Provider Demographics
NPI:1710530399
Name:CUSTER, CHRISTINA (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CUSTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:FRIEDENS
Mailing Address - State:PA
Mailing Address - Zip Code:15541-7104
Mailing Address - Country:US
Mailing Address - Phone:814-701-6205
Mailing Address - Fax:
Practice Address - Street 1:277 HOFFMAN AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-2369
Practice Address - Country:US
Practice Address - Phone:814-467-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily