Provider Demographics
NPI:1356170625
Name:TIPTON, CHRISTINA ADELAIDE (PA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ADELAIDE
Last Name:TIPTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2505 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4464
Mailing Address - Country:US
Mailing Address - Phone:850-233-3376
Mailing Address - Fax:850-522-8354
Practice Address - Street 1:1050 THOMAS AVE
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-6071
Practice Address - Country:US
Practice Address - Phone:877-231-3376
Practice Address - Fax:850-522-8354
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA12720363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant