Provider Demographics
NPI:1427712686
Name:LAND, CHRISTINE LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:LAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NW TERRE VIEW DR APT E20
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-3675
Mailing Address - Country:US
Mailing Address - Phone:208-660-5889
Mailing Address - Fax:
Practice Address - Street 1:825 SE BISHOP BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5517
Practice Address - Country:US
Practice Address - Phone:509-339-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60730431163WP0808X, 390200000X
WA61369481363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program