Provider Demographics
NPI:1164734240
Name:BEATTIE, CHRISTIE JEANNE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:JEANNE
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3668 N HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-6914
Mailing Address - Country:US
Mailing Address - Phone:800-230-7526
Mailing Address - Fax:208-376-9444
Practice Address - Street 1:3668 N HARBOR LN
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6914
Practice Address - Country:US
Practice Address - Phone:800-230-7526
Practice Address - Fax:208-376-9444
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-973A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily