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CHRISTINE PLASIC-VAN WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
283 S BUTLER RD, LEBANON, PA 17042-8939
(717) 273-8871
Mailing address
785 5TH AVE STE 3, CHAMBERSBURG, PA 17201-4232
(717) 263-9555
(717) 709-6529

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP010192
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102747150
PA
01
12408945
CAQH
01
RN212931L
STATE LICENSE - RN
PA
01
SP010192
STATE LICENSE - CRNP
PA
Enumeration date
06/04/2012
Last updated
08/07/2023
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