Provider Demographics
NPI:1528404258
Name:HOLLENKAMP, CHRISTINE ROSE (CPNP, MAN, RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ROSE
Last Name:HOLLENKAMP
Suffix:
Gender:F
Credentials:CPNP, MAN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-1917
Mailing Address - Country:US
Mailing Address - Phone:320-281-3339
Mailing Address - Fax:
Practice Address - Street 1:111 2ND ST S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-1917
Practice Address - Country:US
Practice Address - Phone:320-281-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 191057-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics