Provider Demographics
NPI:1114680311
Name:CHRISTENSEN, CHRISTINA FRANCES (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FRANCES
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 LAUREL MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7891
Mailing Address - Country:US
Mailing Address - Phone:803-372-8622
Mailing Address - Fax:
Practice Address - Street 1:300 BILLINGSLEY RD STE 200A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1075
Practice Address - Country:US
Practice Address - Phone:704-372-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25145363LA2200X
NC5016208363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health