Individual
CHRISTEN MARIE MACKORELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2790
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3043PA
—
SC
Enumeration date
07/26/2017
Last updated
08/11/2026
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