Provider Demographics
NPI:1336979947
Name:ISCHE, CHRISTINA BETH (CNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:BETH
Last Name:ISCHE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 10TH ST W APT 201
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-2801
Mailing Address - Country:US
Mailing Address - Phone:612-384-0174
Mailing Address - Fax:
Practice Address - Street 1:39 10TH ST W APT 201
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-2801
Practice Address - Country:US
Practice Address - Phone:612-384-0174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11933363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology