| Doctor Name: | CHRISTINE HARRELL |
| NPI Number: | 1295732576 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 3874 |
| Business Practice Address: | 120 N Lee St Ste G Forsyth, GA - 310292122 |
| Business Phone Number: | 4789940437 |
| Business Fax Number: | 4789946787 |
| Mailing Address: | 2490 Riverside Dr, Ste B MACON |
| State: | GA |
| Postal Code: | 312041787 |
| Phone Number: | 4786336633 |
| Fax Number: | 4786334295 |
| NPI Enumeration Date: | 07/01/2005 |
| NPI Last Update Date: | 06/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 3874 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |