Provider Demographics
NPI:1790156560
Name:CHRISTENSEN, JEANNE E (MPT)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:E
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 S 147TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2048
Mailing Address - Country:US
Mailing Address - Phone:402-250-7767
Mailing Address - Fax:
Practice Address - Street 1:20601 GLENN ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2325
Practice Address - Country:US
Practice Address - Phone:402-289-2579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10792251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics