Provider Demographics
NPI:1114137197
Name:CHRISTIAN, CATHALENE BLAKE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CATHALENE
Middle Name:BLAKE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CATHALENE
Other - Middle Name:ANN
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:44330 MERCURE CI.
Mailing Address - Street 2:SUITE 240
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20166
Mailing Address - Country:US
Mailing Address - Phone:571-232-8601
Mailing Address - Fax:202-444-2130
Practice Address - Street 1:44330 MERCURE CI.
Practice Address - Street 2:SUITE 240
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166
Practice Address - Country:US
Practice Address - Phone:571-232-8601
Practice Address - Fax:202-444-2130
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA030457363AS0400X
VA0110002395363AS0400X, 363A00000X
MDC0003285363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical