Provider Demographics
NPI:1588824072
Name:CHRISTIANSEN, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 LAFAYETTE RD
Mailing Address - Street 2:APT 101
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2268
Mailing Address - Country:US
Mailing Address - Phone:978-206-1645
Mailing Address - Fax:
Practice Address - Street 1:428 LAFAYETTE RD
Practice Address - Street 2:APT 101
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2268
Practice Address - Country:US
Practice Address - Phone:978-206-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2018-10-31
Deactivation Date:2018-10-08
Deactivation Code:
Reactivation Date:2018-10-31
Provider Licenses
StateLicense IDTaxonomies
NH15053207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine