Provider Demographics
NPI:1851388284
Name:GEMMA, CHRISTINA G (PAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:G
Last Name:GEMMA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 TIPPECANOE RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9008
Mailing Address - Country:US
Mailing Address - Phone:330-729-2737
Mailing Address - Fax:330-729-2742
Practice Address - Street 1:6470 TIPPECANOE RD
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9008
Practice Address - Country:US
Practice Address - Phone:330-729-2737
Practice Address - Fax:330-729-2742
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2349363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant