Provider Demographics
NPI:1194243709
Name:O'HARA-RODRIGUEZ, CHRISTINA JOANNE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JOANNE
Last Name:O'HARA-RODRIGUEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6042
Mailing Address - Country:US
Mailing Address - Phone:781-443-5007
Mailing Address - Fax:
Practice Address - Street 1:803 RIVER RUN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6042
Practice Address - Country:US
Practice Address - Phone:781-443-5007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant