Provider Demographics
NPI:1821026121
Name:PATTERSON, CHRISTINA M (PAC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:SOWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:25 MONUMENT RD
Mailing Address - Street 2:SUITE 294
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5060
Mailing Address - Country:US
Mailing Address - Phone:717-741-9229
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 294
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-741-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003477L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA047698Medicare ID - Type Unspecified