Provider Demographics
NPI:1457622078
Name:SUTTON, CHRISTY LYNN (FNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:LYNN
Last Name:SUTTON
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 1:700 W IRONWOOD DRIVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4462
Mailing Address - Country:US
Mailing Address - Phone:208-772-8940
Mailing Address - Fax:208-625-2075
Practice Address - Street 1:1334 N WHITMAN LN
Practice Address - Street 2:SUITE 200
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-6034
Practice Address - Country:US
Practice Address - Phone:509-688-6700
Practice Address - Fax:509-688-6724
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60658014363LF0000X
IDNP1151363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00155459OtherRN LICENSE
ID1457622078Medicaid
WAAP60658014OtherARNP LICENSE
WA2017335Medicaid