Healthcare Provider Details

I. General information

NPI: 1699223016
Provider Name (Legal Business Name): CHRISTINA EVANS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-8710
  • Fax: 414-805-1101
Mailing address:
  • Phone: 414-805-8710
  • Fax: 414-805-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3897-023
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: