Provider Demographics
NPI:1235159351
Name:CHRISTENSEN, KEITH (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30035 ELMTREE RD
Mailing Address - Street 2:
Mailing Address - City:TREYNOR
Mailing Address - State:IA
Mailing Address - Zip Code:51575-6326
Mailing Address - Country:US
Mailing Address - Phone:402-280-1447
Mailing Address - Fax:
Practice Address - Street 1:2500 CALIFORNIA PLZ
Practice Address - Street 2:CREIGHTON SPAHP, HLSB 118
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68178-1850
Practice Address - Country:US
Practice Address - Phone:402-280-1447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE108041835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist