Provider Demographics
NPI:1023455946
Name:CONSTABLE, CHRISTINE LOUISE (MSN, WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:CONSTABLE
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 WENDY WAY
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4140
Mailing Address - Country:US
Mailing Address - Phone:310-487-7002
Mailing Address - Fax:
Practice Address - Street 1:1805 WENDY WAY
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-4140
Practice Address - Country:US
Practice Address - Phone:310-487-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-01
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557566163WR0006X
CA95001407363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant