Provider Demographics
NPI:1205466133
Name:MCEWEN, CHRISTINE (CRNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MCEWEN
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 1:45 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-9720
Mailing Address - Country:US
Mailing Address - Phone:610-901-3900
Mailing Address - Fax:610-901-3005
Practice Address - Street 1:45 S PINE ST
Practice Address - Street 2:
Practice Address - City:ELVERSON
Practice Address - State:PA
Practice Address - Zip Code:19520-9720
Practice Address - Country:US
Practice Address - Phone:610-901-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019077363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner