Provider Demographics
NPI:1932813912
Name:VASS, CHRISTINE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:VASS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1152 DR THOMAS WALKER RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:VA
Mailing Address - Zip Code:24248-8390
Mailing Address - Country:US
Mailing Address - Phone:865-585-1667
Mailing Address - Fax:
Practice Address - Street 1:779 HIGHWAY 63 STE 1
Practice Address - Street 2:
Practice Address - City:CUMBERLAND GAP
Practice Address - State:TN
Practice Address - Zip Code:37724-4104
Practice Address - Country:US
Practice Address - Phone:423-919-9886
Practice Address - Fax:423-919-9887
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5295363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant