Provider Demographics
NPI:1922602770
Name:DUNCAN, CHRISTINE LYNNE (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNNE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12533 W IRVING ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-2203
Mailing Address - Country:US
Mailing Address - Phone:208-340-4070
Mailing Address - Fax:
Practice Address - Street 1:4545 CORDATA PKWY STE 2C
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7264
Practice Address - Country:US
Practice Address - Phone:360-752-5165
Practice Address - Fax:360-752-5686
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID41811163W00000X
ID66514363L00000X
WAAP61268308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner