Provider Demographics
NPI:1326256769
Name:CHRISTENSON, ARDYS LOUISE (RNC, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:ARDYS
Middle Name:LOUISE
Last Name:CHRISTENSON
Suffix:
Gender:F
Credentials:RNC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14730 55TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-3278
Mailing Address - Country:US
Mailing Address - Phone:763-497-5045
Mailing Address - Fax:
Practice Address - Street 1:14730 55TH ST NE
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-3278
Practice Address - Country:US
Practice Address - Phone:763-497-5045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR053462-8163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant