Provider Demographics
NPI:1609552793
Name:CHRISTENSEN, KENDRA LEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:LEE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LOST CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-9757
Mailing Address - Country:US
Mailing Address - Phone:785-614-4502
Mailing Address - Fax:
Practice Address - Street 1:2265 S 9TH ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7308
Practice Address - Country:US
Practice Address - Phone:785-452-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82370-111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004970030001Medicaid