Provider Demographics
NPI:1245562123
Name:LAND, CHRISTINE CATHERINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:CATHERINE
Last Name:LAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:CATHERINE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:402-559-6195
Mailing Address - Fax:
Practice Address - Street 1:EMILE 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0001
Practice Address - Country:US
Practice Address - Phone:402-559-5600
Practice Address - Fax:402-559-7900
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1489363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant