Provider Demographics
NPI:1457632697
Name:CHRISTENSEN, ROSE GABRIELLE (PAC)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:GABRIELLE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 FRANKLIN ST STE 450
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1128
Mailing Address - Country:US
Mailing Address - Phone:303-321-1333
Mailing Address - Fax:
Practice Address - Street 1:1830 FRANKLIN ST STE 450
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1128
Practice Address - Country:US
Practice Address - Phone:303-321-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21766363AS0400X
COPA0003556363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical