Provider Demographics
NPI:1376604942
Name:CHRISTENSON, JANELL (RN - CNS)
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:
Last Name:CHRISTENSON
Suffix:
Gender:F
Credentials:RN - CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CIVIC CENTER PLZ STE 2116
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-7789
Mailing Address - Country:US
Mailing Address - Phone:507-625-4373
Mailing Address - Fax:
Practice Address - Street 1:12 CIVIC CENTER PLZ STE 2116
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-7789
Practice Address - Country:US
Practice Address - Phone:507-625-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN929301101YM0800X, 163WA0400X
SD929301101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD40693Medicare ID - Type UnspecifiedMEDICARE PROV #