Christina Van Der Meulen, L.AC.
Individual provider Active NPI Acupuncturist · Bellevue, ID
NPI 1487063772 · NPPES record last updated Aug 12, 2014
Key facts
- NPI
- 1487063772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- ACU 140 (ID)
- Practice address
- 717 Elm St.
Bellevue, ID 83313 - Phone
- (208) 720-6513
- Fax
- (208) 788-2287
- NPI assigned
- Aug 12, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACU 140 | ID | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | ACU 140 | ID | Yes |
Addresses
Primary practice location
717 Elm St.
Bellevue, ID 83313
Mailing address
PO Box 4588
Hailey, ID 83333-4588
Phone (208) 720-6513
Other providers in Bellevue, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.