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General NPI Number Information
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NPI Number | 1326095233
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Entity Type | Individual
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Provider Name | CHRISTI ALISE CAMPBELL RN
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Gender | Female
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 360 E MALLARD DR #110
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City | BOISE
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State | ID
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Zip | 83706-6644
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Country | US
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Telephone | 208-386-3306
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Fax | 208-426-0902
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Provider Business Mailing Address
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Address Line | 9436 W MOSSY CUP ST
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City | BOISE
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State | ID
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Zip | 83709-3537
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Country | US
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Telephone | 208-362-4936
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Fax | 208-426-0902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX1100X
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Taxonomy Name | Ophthalmic Registered Nurse
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License Number | N-24938
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License Number State | ID
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