Provider Demographics
NPI:1720157480
Name:GOODING, KRISTYN E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTYN
Middle Name:E
Last Name:GOODING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:E
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1918 PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3817
Mailing Address - Country:US
Mailing Address - Phone:717-606-2978
Mailing Address - Fax:717-544-2625
Practice Address - Street 1:540 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2374
Practice Address - Country:US
Practice Address - Phone:717-544-4950
Practice Address - Fax:717-544-2625
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052756363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical