Provider Demographics
NPI:1992481899
Name:MCQUEEN, CHRISTINA ANNE (PMHNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANNE
Last Name:MCQUEEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CORPORATE CENTER DR STE B
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7382
Mailing Address - Country:US
Mailing Address - Phone:470-606-5184
Mailing Address - Fax:
Practice Address - Street 1:175 CORPORATE CENTER DR STE B
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7382
Practice Address - Country:US
Practice Address - Phone:470-606-5184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27673363LP0808X
GARN262542363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health