Provider Demographics
NPI:1003204025
Name:PATROCINIO MASSINGA, CHRISTINE MCCREE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MCCREE
Last Name:PATROCINIO MASSINGA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3250 WILKINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5665
Mailing Address - Country:US
Mailing Address - Phone:704-319-5176
Mailing Address - Fax:
Practice Address - Street 1:3250 WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5665
Practice Address - Country:US
Practice Address - Phone:704-319-5176
Practice Address - Fax:980-819-7900
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001005415363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical