Provider Demographics
NPI:1750320990
Name:NEAL, CHRISTINA LYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LYN
Last Name:NEAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1810 LOG MILL PL
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1856
Mailing Address - Country:US
Mailing Address - Phone:443-292-4151
Mailing Address - Fax:
Practice Address - Street 1:3510 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3233
Practice Address - Country:US
Practice Address - Phone:301-609-5200
Practice Address - Fax:301-609-5220
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0003200363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical