Provider Demographics
NPI:1386846095
Name:EBENS, CHRISTEN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:EBENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 484 MAYO, CAMPUS DELIVERY CODE 8484B
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-365-8100
Mailing Address - Fax:612-365-8101
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:JOURNEY CLINIC, 9TH FLOOR, EAST BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-365-8100
Practice Address - Fax:612-365-8101
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN580112080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology