Provider Demographics
NPI:1528450400
Name:CRISTANCHO, ROXANNE SEBENY (CRNP)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:SEBENY
Last Name:CRISTANCHO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:SEBENY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 WALNUT STREET
Mailing Address - Street 2:16TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-829-0101
Mailing Address - Fax:215-454-3625
Practice Address - Street 1:800 WALNUT STREET
Practice Address - Street 2:16TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-829-0101
Practice Address - Fax:215-454-3625
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily