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General NPI Number Information
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NPI Number | 1447333570
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Entity Type | Individual
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Provider Name | CHRISTINE ANN PHELPS PA
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 3700 KOLBE RD
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City | LORAIN
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State | OH
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Zip | 44053-1611
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Country | US
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Telephone | 440-960-4522
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Fax | 440-960-4523
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Provider Business Mailing Address
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Address Line | 1225 MARSHALL ST SUITE 18
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City | CRESCENT CITY
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State | CA
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Zip | 95531-2281
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Country | US
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Telephone | 707-464-1989
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13857
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | OH
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