Provider Demographics
NPI:1699230219
Name:BAUMERT, CHRISTINA SIMPSON (PA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:SIMPSON
Last Name:BAUMERT
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2149 E WARNER RD
Mailing Address - Street 2:STE 102
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3495
Mailing Address - Country:US
Mailing Address - Phone:480-610-6100
Mailing Address - Fax:480-610-6189
Practice Address - Street 1:30 MEDICAL CENTER BLVD STE 202
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3956
Practice Address - Country:US
Practice Address - Phone:610-447-8840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA060501363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA060501OtherLICENSE