Healthcare Provider Details

I. General information

NPI: 1841456878
Provider Name (Legal Business Name): CHRISTINA LYNN VANNOCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17100 E SHEA BLVD STE 600
FOUNTAIN HILLS AZ
85268-6663
US

IV. Provider business mailing address

16620 S 48TH ST UNIT 42
PHOENIX AZ
85048-1205
US

V. Phone/Fax

Practice location:
  • Phone: 480-837-4565
  • Fax:
Mailing address:
  • Phone: 507-951-3056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP5949
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: