Provider Demographics
NPI:1326006008
Name:CHRISTENSEN, KECIA A (APRN)
Entity Type:Individual
Prefix:
First Name:KECIA
Middle Name:A
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 31ST ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3466
Mailing Address - Country:US
Mailing Address - Phone:402-844-8190
Mailing Address - Fax:402-844-8191
Practice Address - Street 1:301 N 31ST ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3466
Practice Address - Country:US
Practice Address - Phone:402-844-8190
Practice Address - Fax:402-844-8191
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110315363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557520Medicaid
NEP40026Medicare UPIN
NE47078557520Medicaid