Provider Demographics
NPI:1457151268
Name:LECOURS, CHRISTINE MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:LECOURS
Suffix:
Gender:
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 1:4180 POSSUM RUN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-4000
Mailing Address - Country:US
Mailing Address - Phone:714-334-8769
Mailing Address - Fax:
Practice Address - Street 1:8210 SPRINGBORO PIKE
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3705
Practice Address - Country:US
Practice Address - Phone:937-557-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.009357RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant