Provider Demographics
NPI:1417346933
Name:AMEN, CHRISTOPHER NELSON
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NELSON
Last Name:AMEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-1909
Mailing Address - Country:US
Mailing Address - Phone:406-452-6461
Mailing Address - Fax:406-452-4833
Practice Address - Street 1:2515 6TH AVE N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-1909
Practice Address - Country:US
Practice Address - Phone:406-452-6461
Practice Address - Fax:406-452-4833
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-25435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist