Provider Demographics
NPI:1558558106
Name:CHRISTENSEN, DORIS G (FNP)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:G
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E 400 N
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-2626
Mailing Address - Country:US
Mailing Address - Phone:435-613-5629
Mailing Address - Fax:435-613-5992
Practice Address - Street 1:451 E 400 N
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-2626
Practice Address - Country:US
Practice Address - Phone:435-613-5629
Practice Address - Fax:435-613-5992
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2207598900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily