Provider Demographics
NPI:1467125278
Name:WAHL, CHRISTEN (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:WAHL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTEN
Other - Middle Name:
Other - Last Name:SHERRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 BRECKENRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1089
Mailing Address - Country:US
Mailing Address - Phone:270-683-8672
Mailing Address - Fax:
Practice Address - Street 1:1200 BRECKENRIDGE ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1089
Practice Address - Country:US
Practice Address - Phone:270-683-8672
Practice Address - Fax:270-685-8223
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily