Provider Demographics
NPI:1942922760
Name:FRIEDRICH, CHRISTIE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:FRIEDRICH
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10034 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:17327-8421
Mailing Address - Country:US
Mailing Address - Phone:717-654-8700
Mailing Address - Fax:
Practice Address - Street 1:2113 MANOR RIDGE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4215
Practice Address - Country:US
Practice Address - Phone:717-299-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063941363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant