Provider Demographics
NPI:1437307758
Name:TROTTIER, CHRISTINE A (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:TROTTIER
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 1:23511 HOLLYWOOD RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-5833
Mailing Address - Country:US
Mailing Address - Phone:301-997-0611
Mailing Address - Fax:301-997-0709
Practice Address - Street 1:23511 HOLLYWOOD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-5833
Practice Address - Country:US
Practice Address - Phone:301-997-0611
Practice Address - Fax:301-997-0709
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003790363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical