Provider Demographics
NPI:1750486254
Name:CHRISTENSEN, JANIE S (CRNA)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:S
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 S 500 W
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:UT
Mailing Address - Zip Code:84653-9304
Mailing Address - Country:US
Mailing Address - Phone:801-423-1969
Mailing Address - Fax:
Practice Address - Street 1:1000 E 100 N
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-1600
Practice Address - Country:US
Practice Address - Phone:801-174-8486
Practice Address - Fax:801-733-5872
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT187107-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT48252OtherPEHP
UT870525882CH2OtherEDUCATORS MUTUAL
UT193294OtherIHC
UT343840OtherDESERET MUTUAL
UTPRA02845OtherMOLINA
UTQM0000076595OtherALTIUS
UT343840OtherDESERET MUTUAL