Provider Demographics
NPI:1992112023
Name:FAHR, CHRISTINE LOUISE (CRNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:FAHR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 WARD DR
Mailing Address - Street 2:
Mailing Address - City:CLAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16625-8219
Mailing Address - Country:US
Mailing Address - Phone:814-239-2211
Mailing Address - Fax:814-239-8116
Practice Address - Street 1:365 WARD DR
Practice Address - Street 2:
Practice Address - City:CLAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16625-8219
Practice Address - Country:US
Practice Address - Phone:814-239-2211
Practice Address - Fax:814-239-8116
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP 013983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily