Provider Demographics
NPI:1184871055
Name:TRUEBLOOD, CHRISTINE A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:TRUEBLOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3405
Mailing Address - Country:US
Mailing Address - Phone:816-221-0305
Mailing Address - Fax:816-221-9121
Practice Address - Street 1:2029 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3405
Practice Address - Country:US
Practice Address - Phone:816-221-0305
Practice Address - Fax:816-221-9121
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090115152084P0800X
KS94-05772390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry