Provider Demographics
NPI:1396207734
Name:CHRISTENSEN, CAMILLE ANDREA (DPM)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ANDREA
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5676 STEUBENVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1437
Mailing Address - Country:US
Mailing Address - Phone:678-925-9719
Mailing Address - Fax:
Practice Address - Street 1:5676 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1437
Practice Address - Country:US
Practice Address - Phone:678-925-9719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC007249213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery