Provider Demographics
NPI:1437433620
Name:CHRISTIANSEN, AMY LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LOUISE
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4300 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7005
Mailing Address - Country:US
Mailing Address - Phone:907-235-0306
Mailing Address - Fax:907-235-0810
Practice Address - Street 1:4300 BARTLETT ST
Practice Address - Street 2:ATTN:A. CHRISTIANSEN RN @COMMUNITY HEALTH SERVICES
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7005
Practice Address - Country:US
Practice Address - Phone:907-235-0306
Practice Address - Fax:907-235-0810
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNUR R 28534163W00000X
AKVET T 462472V0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No2472V0600XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherVeterinary