| NPI | 1811065626 |
|---|---|
| Doing Business As | WELLSPAN FAMILY MEDICINE - BANNISTER ST |
| Entity Type | Organization |
| Authorized Contact | CHRISTINA VEST Credentialing Supervisor 717-851-1405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2018-01-11 |