Provider Demographics
NPI:1316403603
Name:EIB, CHRISTY (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:EIB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2768
Mailing Address - Country:US
Mailing Address - Phone:360-575-7811
Mailing Address - Fax:360-575-7220
Practice Address - Street 1:1225 28TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2768
Practice Address - Country:US
Practice Address - Phone:360-575-7811
Practice Address - Fax:360-575-7220
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00165905163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool