Park, Christine
Park, Christine is an individual health care provider with primary practice located at 347 Smith Ave N , Saint Paul MN 55102-2387. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Park, Christine can be contacted via phone (651) 220-6789.Contact Information
Primary practice address
347 Smith Ave N
Saint Paul MN 55102-2387
Phone: (651) 220-6789
Fax: (651) 220-6807
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | R134132-8 | Minnesota |
Profile Details
| NPI number | 1730188699 |
|---|---|
| LBN Legal business name | Park, Christine |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Nov 30th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730188699 | NPPES |
| Minnesota | MEDICAID | 345804100 |
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