Provider Demographics
NPI:1730216524
Name:STOCKWELL, CHRISTINA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:STOCKWELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:BURNS-SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1930 ALCOA HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1510
Mailing Address - Country:US
Mailing Address - Phone:865-546-1642
Mailing Address - Fax:865-305-6195
Practice Address - Street 1:1930 ALCOA HWY STE 240
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1510
Practice Address - Country:US
Practice Address - Phone:865-546-1642
Practice Address - Fax:865-305-6195
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0002943207V00000X
TNDO0000001960207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology