Basic Information
Provider Information
NPI: 1467068858
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHRISTY
FirstName: MORGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1605 LITITZ PIKE
Address2:  
City: LANCASTER
State: PA
PostalCode: 176016507
CountryCode: US
TelephoneNumber: 7177353995
FaxNumber:  
Practice Location
Address1: 1655 CROOKED OAK DR
Address2:  
City: LANCASTER
State: PA
PostalCode: 176014207
CountryCode: US
TelephoneNumber: 7177353995
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/21/2020
LastUpdateDate: 02/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP022289PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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