Provider Demographics
NPI:1932339678
Name:SELL, CHRISTINA L (ARNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:SELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:L
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:24077 EPPERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:51534-5102
Mailing Address - Country:US
Mailing Address - Phone:095-590-5507
Mailing Address - Fax:
Practice Address - Street 1:6001 N MAYFAIR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208
Practice Address - Country:US
Practice Address - Phone:509-462-2273
Practice Address - Fax:509-462-2275
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA0209186363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0252289OtherLABOR AND INDUSTRIES
ID1932339678Medicaid
WA9662321Medicaid
WA0252289OtherLABOR AND INDUSTRIES
WA5048140002Medicare NSC