Provider Demographics
NPI:1194379230
Name:HAAG, CHRISTINA (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:HAAG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6585 S DELMAR PL
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-4062
Mailing Address - Country:US
Mailing Address - Phone:480-298-5501
Mailing Address - Fax:
Practice Address - Street 1:255 S DOBSON RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6231
Practice Address - Country:US
Practice Address - Phone:480-722-2595
Practice Address - Fax:480-722-2599
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14475363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant