Provider Demographics
NPI:1619402070
Name:BAKER, CHRISTINA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:BAKER
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 1:1235 PROVIDENCE RD NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4105
Mailing Address - Country:US
Mailing Address - Phone:330-412-4096
Mailing Address - Fax:
Practice Address - Street 1:2859 AARONWOOD AVE NE
Practice Address - Street 2:SUITE #3
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2390
Practice Address - Country:US
Practice Address - Phone:330-832-2280
Practice Address - Fax:330-832-4732
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical