Provider Demographics
NPI:1275052664
Name:ANDREEN, CHRISTIAN (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:ANDREEN
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 1:3352 E ROADRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-5704
Mailing Address - Country:US
Mailing Address - Phone:602-312-9945
Mailing Address - Fax:888-503-3312
Practice Address - Street 1:1901 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8306
Practice Address - Country:US
Practice Address - Phone:480-999-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-17
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7939960001332B00000X
AZ7046960001332B00000X
AZ704516001332B00000X
AZ7209350001332B00000X
AZ7629170001332B00000X
AZ6861363A00000X, 363AM0700X
363AM0700X
AZ7057360001332B00000X
AZ70349500001332B00000X
AZ7047150001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant