Individual
CHRISTINE CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 N 1075 W, BLACKFOOT, ID 83221-6402
(307) 248-1580
Mailing address
124 N 1075 W, BLACKFOOT, ID 83221-6402
(307) 248-1580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
55771
ID
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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