Provider Demographics
NPI:1093926248
Name:CHRISTIANSEN, DORIS ANN (RN, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:RN, IBCLC, RLC
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:
Other - Last Name:CHRISTIANSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, IBCLC, RLC
Mailing Address - Street 1:2464 E MENLO ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-1583
Mailing Address - Country:US
Mailing Address - Phone:480-833-2262
Mailing Address - Fax:
Practice Address - Street 1:2464 E MENLO ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-1583
Practice Address - Country:US
Practice Address - Phone:480-833-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN082560163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant