Provider Demographics
NPI:1093361180
Name:CHRISTENSON, MELISSA SUE (CNM, WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:SUE
Last Name:CHRISTENSON
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 N 19TH AVE
Mailing Address - Street 2:STE 222
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1106
Mailing Address - Country:US
Mailing Address - Phone:602-283-3668
Mailing Address - Fax:602-258-1710
Practice Address - Street 1:6707 N 19TH AVE STE 222
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1106
Practice Address - Country:US
Practice Address - Phone:602-283-3668
Practice Address - Fax:877-977-9438
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230917207V00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty