Provider Demographics
NPI:1538647029
Name:CHRONISTER, BRITTANY COOMBS (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:COOMBS
Last Name:CHRONISTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:COOMBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29863 FARMWAY RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-8679
Mailing Address - Country:US
Mailing Address - Phone:208-830-3270
Mailing Address - Fax:
Practice Address - Street 1:1219 SW 4TH AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-4500
Practice Address - Country:US
Practice Address - Phone:541-889-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201805416NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily