Provider Demographics
NPI:1225317415
Name:CHRISTENSEN, PHYLLIS (RN)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 CROSS PARK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5154
Mailing Address - Country:US
Mailing Address - Phone:512-459-1000
Mailing Address - Fax:512-452-6855
Practice Address - Street 1:8305 CROSS PARK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5154
Practice Address - Country:US
Practice Address - Phone:512-459-1000
Practice Address - Fax:512-452-6855
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628692251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health