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General NPI Number Information
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NPI Number | 1487697827
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Entity Type | Individual
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Provider Name | CHRISTINE M PAYNTER PA C
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 425 W BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83702-6035
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Country | US
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Telephone | 208-343-6458
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83702-6035
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10004766
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 506
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 058
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License Number State | ID
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