Individual
LADESSA MARIE CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7442
(208) 898-7467
(208) 398-2120
Mailing address
4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7442
(208) 898-7467
(208) 398-2120
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201600702
OR
363LF0000X
Family Nurse Practitioner
5173942-4405
UT
363LF0000X
Family Nurse Practitioner
5173942-8900
UT
363LF0000X
Family Nurse Practitioner
Primary
68154
ID
363LF0000X
Family Nurse Practitioner
AP60628138
WA
Other
Enumeration date
11/20/2013
Last updated
11/29/2021
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