Provider Demographics
NPI:1124382759
Name:CHRISTENSEN, RACHELLE MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:MARIE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 24TH AVE
Mailing Address - Street 2:T-0632
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3806
Mailing Address - Country:US
Mailing Address - Phone:313-806-6637
Mailing Address - Fax:
Practice Address - Street 1:20877 HALL RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4256
Practice Address - Country:US
Practice Address - Phone:586-464-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist