Provider Demographics
NPI:1407399215
Name:BACHER, CHRISTINA BLANCA (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:BLANCA
Last Name:BACHER
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 1:949 CARDOVA DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4210
Mailing Address - Country:US
Mailing Address - Phone:407-506-5436
Mailing Address - Fax:
Practice Address - Street 1:949 CARDOVA DR NE STE 4025
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4210
Practice Address - Country:US
Practice Address - Phone:407-506-5436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8250363AM0700X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical