Provider Demographics
NPI:1073984639
Name:TRETTER, CHRISTINA (AGNP-T)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TRETTER
Suffix:
Gender:F
Credentials:AGNP-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6289
Mailing Address - Country:US
Mailing Address - Phone:480-501-9475
Mailing Address - Fax:
Practice Address - Street 1:77 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6289
Practice Address - Country:US
Practice Address - Phone:480-501-9475
Practice Address - Fax:480-306-7674
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP8161363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health