Provider Demographics
NPI:1043598899
Name:BULLEY, CHRISTINA LEE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:LEE
Last Name:BULLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 MONTROSE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3363
Mailing Address - Country:US
Mailing Address - Phone:301-588-7888
Mailing Address - Fax:301-588-3419
Practice Address - Street 1:7811 MONTROSE RD STE 340
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3363
Practice Address - Country:US
Practice Address - Phone:301-588-7888
Practice Address - Fax:301-588-3419
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC06718363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant