Basic Information
| Provider Information | |||||||||
| NPI: | 1336876978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCELNEA | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | PMHNP - BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15431 N 170TH CT | ||||||||
| Address2: | |||||||||
| City: | SURPRISE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853881322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023507997 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2400 W DUNLAP AVE STE 124 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850212813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023995792 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2022 | ||||||||
| LastUpdateDate: | 08/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 278400 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.