Provider Demographics
NPI:1811946379
Name:MARSHALL, CHRISTIANNE ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTIANNE
Middle Name:ELIZABETH
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PA-C
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Other - Middle Name:
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Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DR, 4TH FLOOR
Practice Address - Street 2:C.S. MOTT CHILDREN'S HOSPITAL
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4217
Practice Address - Country:US
Practice Address - Phone:734-764-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002131363A00000X
DCPA030387363A00000X
MI5601005233363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant