Provider Demographics
NPI:1962550996
Name:SPECHT, CHRISTINE MARIE (MSN, RN, PMHCNS-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:SPECHT
Suffix:
Gender:F
Credentials:MSN, RN, PMHCNS-BC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:DOLESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, CS
Mailing Address - Street 1:106 S NEW MIDDLETOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:610-999-6599
Mailing Address - Fax:
Practice Address - Street 1:1199 LANCASTER AVENUE
Practice Address - Street 2:SUITE 106
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312
Practice Address - Country:US
Practice Address - Phone:610-999-6599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-288767L163WP0807X
PARN288767L364SP0807X
PACNS000059364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent