Provider Demographics
NPI:1578590493
Name:CHRISTIANSEN, JESSICA LINNEY (DC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LINNEY
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5104 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2360
Mailing Address - Country:US
Mailing Address - Phone:402-933-6208
Mailing Address - Fax:402-933-6170
Practice Address - Street 1:5104 S 108TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2360
Practice Address - Country:US
Practice Address - Phone:402-933-6208
Practice Address - Fax:402-933-6170
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025209100Medicaid
NE10025209100Medicaid