Provider Demographics
NPI:1942332598
Name:CHRISTIAN FAMILY HOUSE CALLS, LLC
Entity Type:Organization
Organization Name:CHRISTIAN FAMILY HOUSE CALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:940-224-9274
Mailing Address - Street 1:2810 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76309-4024
Mailing Address - Country:US
Mailing Address - Phone:940-224-9274
Mailing Address - Fax:940-569-4969
Practice Address - Street 1:2810 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-4024
Practice Address - Country:US
Practice Address - Phone:940-224-9274
Practice Address - Fax:940-569-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP41895Medicare UPIN
TX87966HMedicare ID - Type Unspecified