Provider Demographics
NPI:1710368238
Name:KOSICH, CHRISTINA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:KOSICH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:O'SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:157 BALTIMORE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2472
Mailing Address - Country:US
Mailing Address - Phone:301-722-0484
Mailing Address - Fax:833-903-0130
Practice Address - Street 1:100 ABBEYVILLE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4604
Practice Address - Country:US
Practice Address - Phone:301-722-0484
Practice Address - Fax:833-903-0130
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014973363L00000X
DELG-0000948363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner