Individual
MS. PATRICIA MARLENA CHRISTOPHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
260 BETH STACEY BLVD, SUITE 130, LEHIGH ACRES, FL 33936-6074
(239) 369-4088
(239) 369-0588
Mailing address
8500 BALBOA BLVD, NORTHRIDGE, CA 91325-5802
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
51979
CA
363AM0700X
Medical Physician Assistant
PA9104285
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51979
PALICENSE
CA
01
—
CQ690Y
MEDICARE PTAN
FL
01
—
PA9104285
PA LICENSE
FL
Enumeration date
02/05/2009
Last updated
01/16/2026
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