Provider Demographics
NPI:1134558885
Name:HORRELL, CHRISTOPHER ROSS (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ROSS
Last Name:HORRELL
Suffix:
Gender:M
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 1:828 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1730
Mailing Address - Country:US
Mailing Address - Phone:724-547-4441
Mailing Address - Fax:
Practice Address - Street 1:828 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1730
Practice Address - Country:US
Practice Address - Phone:724-547-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant