Provider Information for 1821667957
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CHRISTYN EVE JAAP
Sex: Female
NPI: 1821667957
Last Updated: 2023-07-18
Certification Date: 2023-07-17
Certification Date: 2023-07-17
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1821667957 | ||||||||
| Enumeration Date | 2021-06-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 911 W LOOP 281 STE 211-15 LONGVIEW, TX 75604-2900 United States Phone: 903-261-5114 | Fax: | ||||||||
| Primary Practice Address | 911 W LOOP 281 STE 211-15 LONGVIEW, TX 75604-2900 United States Phone: 903-261-5114 | Fax: | ||||||||
| Secondary Practice Address(es) | 1700 COVEMEADOW DR | ||||||||
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