Individual
CORAL D FASSNACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1500 HIGHLANDS DR, LITITZ, PA 17543-7694
(717) 325-5000
Mailing address
1500 HIGHLANDS DR, LITITZ, PA 17543-7694
(717) 325-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN193985L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001799937
—
PA
Enumeration date
06/13/2006
Last updated
11/28/2016
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