Provider Demographics
NPI:1295409449
Name:CHRISTENSEN, BRIDGETTE ANN
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:ANN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 LEAVENWORTH ST APT 224
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2973
Mailing Address - Country:US
Mailing Address - Phone:402-826-0166
Mailing Address - Fax:
Practice Address - Street 1:415 LEAVENWORTH ST APT 224
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-2973
Practice Address - Country:US
Practice Address - Phone:402-826-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1712225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant