Doctor Name: | MR. CHRISTOPHER IAN EARLE |
NPI Number: | 1003242314 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DNP |
License Number: | AP5159 |
Business Practice Address: | 30775 N 126th Ave Peoria, AZ - 853837878 |
Business Phone Number: | 6026898965 |
Business Fax Number: | |
Mailing Address: | 30775 N 126th Ave, PEORIA |
State: | AZ |
Postal Code: | 853837878 |
Phone Number: | 6026898965 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2013 |
NPI Last Update Date: | 09/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | AP5159 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |