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Individual

CHRISTINE T LONGORIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2501 W BELTLINE HWY STE 601, MADISON, WI 53713-2309
(608) 234-7436
(866) 939-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(623) 434-2115
(623) 544-5531

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1605-23
WI
363AM0700X
Medical Physician Assistant
1605-023
WI
363AS0400X
Surgical Physician Assistant
1605-023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41978300
WI
Enumeration date
05/04/2006
Last updated
10/07/2025
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