1023496601 NPI number — DR. CHRISTY CATHERINE NIELSEN PHARMD

Table of content: DR. CHRISTY CATHERINE NIELSEN PHARMD (NPI 1023496601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023496601 NPI number — DR. CHRISTY CATHERINE NIELSEN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIELSEN
Provider First Name:
CHRISTY
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023496601
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 908
Provider Second Line Business Mailing Address:
LAKE CHELAN COMMUNITY HOSPITAL
Provider Business Mailing Address City Name:
CHELAN
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98816-8631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-726-6020
Provider Business Mailing Address Fax Number:
509-682-1025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 E HIGHLAND AVE
Provider Second Line Business Practice Location Address:
LAKE CHELAN COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
CHELAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98816-8631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-726-6020
Provider Business Practice Location Address Fax Number:
509-682-1027
Provider Enumeration Date:
05/14/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  00010804 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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