Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | M-14951 | ID |
N | 207P00000X | Emergency Physician | MD60692626 | WA |
NPI | 1003250739 |
---|---|
Provider Name | Christina Crabtree |
First Address | Coeur D Alene, ID 83814-6051 |
Second Address | Coeur D Alene, ID 83814-6051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 15/11/2021 |