Healthcare Provider Details

I. General information

NPI: 1437591823
Provider Name (Legal Business Name): CHRISTINE SAUNDERS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE FEHRMANN PA

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 05/01/2024
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MONTGOMERY BLVD NE STE B100
ALBUQUERQUE NM
87109-1206
US

IV. Provider business mailing address

4600 MONTGOMERY BLVD NE STE 100
ALBUQUERQUE NM
87109-1210
US

V. Phone/Fax

Practice location:
  • Phone: 505-924-5840
  • Fax: 505-924-5841
Mailing address:
  • Phone: 505-924-5840
  • Fax: 505-924-5841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110004311
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2014-0008
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA2014-0008
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberPA2014-0008
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: