Provider Demographics
NPI:1487336244
Name:CHRISTIAN, ANNIE KATHLEEN
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:KATHLEEN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 THUNDER WAY NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-1795
Mailing Address - Country:US
Mailing Address - Phone:404-797-9709
Mailing Address - Fax:
Practice Address - Street 1:3708 THUNDER WAY NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-1795
Practice Address - Country:US
Practice Address - Phone:404-797-9709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant