Provider Demographics
NPI:1568641066
Name:CHRISTOPHER, STEPHANIE E (PA-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:E
Last Name:CHRISTOPHER
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 1:4120 FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1638
Mailing Address - Country:US
Mailing Address - Phone:303-455-4761
Mailing Address - Fax:303-455-5207
Practice Address - Street 1:4120 FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1638
Practice Address - Country:US
Practice Address - Phone:303-455-4761
Practice Address - Fax:303-455-5207
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1965363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant