Provider Demographics
NPI:1184910127
Name:CIACCIO, CHRISTINA M (LPN)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:M
Last Name:CIACCIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N CAMERON ST
Mailing Address - Street 2:SUITE 401 WEST, 4TH FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-2424
Mailing Address - Country:US
Mailing Address - Phone:717-232-2946
Mailing Address - Fax:717-232-3519
Practice Address - Street 1:100 N CAMERON ST
Practice Address - Street 2:SUITE 401 WEST, 4TH FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2424
Practice Address - Country:US
Practice Address - Phone:717-232-2946
Practice Address - Fax:717-232-3519
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN281327164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse