Basic Information
| Provider Information | |||||||||
| NPI: | 1285396341 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHRISTIAN | ||||||||
| FirstName: | SKYE | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 SANDPIPER LN | ||||||||
| Address2: | |||||||||
| City: | NEW CUMBERLAND | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170702864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177436313 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 503 N 21ST ST | ||||||||
| Address2: | |||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170112204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177632100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2021 | ||||||||
| LastUpdateDate: | 10/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | OA005765 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | MA062686 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AS0400X | MA062686 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AS0400X | OA005765 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.