Provider Demographics
NPI:1548445505
Name:BLACKBURN, CHRISTINE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 BRIDGEPORT WAY W STE F
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4724
Mailing Address - Country:US
Mailing Address - Phone:253-666-6780
Mailing Address - Fax:253-666-6793
Practice Address - Street 1:2603 BRIDGEPORT WAY W STE F
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4724
Practice Address - Country:US
Practice Address - Phone:253-666-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV884292363LF0000X, 363LF0000X
WAAP61584580363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily