Provider Demographics
NPI:1083693717
Name:CHRISTENSEN, KATHERINE EILEEN (APRN - NP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:EILEEN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:APRN - NP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:E
Other - Last Name:SHANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 CAMBRIDGE ST STE G600
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:STE G600
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023150363L00000X
KS53-45804363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200369320BMedicaid
36824015OtherBCBS
925853OtherFIRST GUARD MCO
MO1083693717Medicaid
KS200369320 AMedicaid
MO427445804Medicaid
MO1083693717Medicaid
MOMA2231022Medicare PIN
KS038B00026Medicare PIN
925853OtherFIRST GUARD MCO
Q53415Medicare UPIN
36824015OtherBCBS