Healthcare Provider Details

I. General information

NPI: 1427712686
Provider Name (Legal Business Name): CHRISTINE LOUISE LAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S GRAND AVE STE B
PULLMAN WA
99163-2712
US

IV. Provider business mailing address

405 S GRAND AVE STE B
PULLMAN WA
99163-2712
US

V. Phone/Fax

Practice location:
  • Phone: 509-338-9562
  • Fax: 509-769-0550
Mailing address:
  • Phone: 509-338-9562
  • Fax: 509-769-0550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number60730431
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number61369481
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number60730431
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: