Provider Demographics
NPI:1659380715
Name:CHRISTMAN, MARK S (APNP)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:S
Last Name:CHRISTMAN
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:STEVEN
Other - Last Name:CHRSITMAN
Other - Suffix:
Other - Last Name Type:Doing Business As
Other - Credentials:
Mailing Address - Street 1:1000 MINERAL POINT AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2940
Mailing Address - Country:US
Mailing Address - Phone:608-756-6838
Mailing Address - Fax:608-756-6236
Practice Address - Street 1:248 MCHENRY ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105
Practice Address - Country:US
Practice Address - Phone:262-767-8094
Practice Address - Fax:262-767-8212
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1756-033363L00000X
WI116879-030363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner