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General NPI Number Information
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NPI Number | 1922618933
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Entity Type | Individual
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Provider Name | AVA MIDORI CHRISTENSEN PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 695 KINKAID RD
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City | ANNAPOLIS
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State | MD
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Zip | 21402-1006
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Country | US
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Telephone | 410-293-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 LILLIAN ST
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City | LIVERMORE
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State | CA
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Zip | 94550-3517
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Country | US
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Telephone | 925-337-5559
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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 | PA.0008200
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License Number State | CO
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