Provider Demographics
NPI:1790019941
Name:ROSENGREN, CHRISTINA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:ROSENGREN
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:PO BOX 910221
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0221
Mailing Address - Country:US
Mailing Address - Phone:520-519-7700
Mailing Address - Fax:
Practice Address - Street 1:2070 W RUDASILL RD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7891
Practice Address - Country:US
Practice Address - Phone:520-797-4468
Practice Address - Fax:520-797-7735
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4471363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4471OtherAZ LICENSE