Constance C Christofferson, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

P4169 Issued in ID

Practice address

2655 S Broadway Ave
Boise, ID 83706-4721

Phone

(208) 345-8728

Fax

(208) 343-6591

NPI assigned

Jan 26, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Connie C Christofferson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1841562592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 S BROADWAY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064721",
            "telephone_number": "208-345-8728",
            "fax_number": "208-343-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 S BROADWAY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064721",
            "telephone_number": "208-345-8728",
            "fax_number": "208-343-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOFFERSON",
        "first_name": "CONSTANCE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P4169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "CHRISTOFFERSON",
            "middle_name": "C",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jalane Christenson, LMT
• Celeste Renee Christesen, PA-C
• Patrice Christesen
• Christian G Zimmerman PA
• Jasmine Christie
• Christopher R Wells DMD PC
• Christopher Vaughan, MD PLLC
• Christopher W Hammerle MD CHTD
• Andrea S Christopher, M.D.
• Chrisean Christopher, LCPC

• Pharmacist in Boise, ID
• Providers in Boise, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.