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General NPI Number Information
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NPI Number | 1851894000
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Entity Type | Individual
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Provider Name | CHARLOTTE KRYSTYN STOCKING PNP
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Gender | Female
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 1414 N VERCLER RD STE 1
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1092
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Country | US
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Telephone | 509-928-6383
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Fax | 509-227-7070
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-0421
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Country | US
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Telephone | 866-747-2455
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Fax | 509-227-7070
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9482657
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | 23580
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP61492456
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License Number State | WA
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