Provider Demographics
NPI:1508938671
Name:CHRISTENSEN, DONNA JEAN (RPH)
Entity Type:Individual
Prefix:PROF
First Name:DONNA
Middle Name:JEAN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 S AVALON AVE APT 112
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2411
Mailing Address - Country:US
Mailing Address - Phone:605-271-2024
Mailing Address - Fax:
Practice Address - Street 1:4901 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-0444
Practice Address - Country:US
Practice Address - Phone:605-373-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR5427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist