Provider Demographics
NPI:1932491115
Name:STEVENS, CHRISTY L (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:L
Other - Last Name:EISENHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:717-544-7157
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:717-544-7157
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN519435L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA221045T9AMedicare PIN