Provider Demographics
NPI:1548070840
Name:VINCENT, CHRISTIE DAWN (RN)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:DAWN
Last Name:VINCENT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 NE EASTGATE BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5623
Mailing Address - Country:US
Mailing Address - Phone:509-334-6016
Mailing Address - Fax:
Practice Address - Street 1:1610 NE EASTGATE BLVD STE 650
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5623
Practice Address - Country:US
Practice Address - Phone:509-334-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60164254163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health