Provider Demographics
NPI:1275906844
Name:CHRISTENSEN, MARTIN ERROL (APRN)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:ERROL
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 CLIME RD STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-3496
Mailing Address - Country:US
Mailing Address - Phone:614-274-7799
Mailing Address - Fax:614-274-3209
Practice Address - Street 1:4310 CLIME RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3496
Practice Address - Country:US
Practice Address - Phone:614-274-7799
Practice Address - Fax:614-274-3209
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK93308363LF0000X
OHAPRN.CNP.020256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily