Provider Demographics
NPI:1861505893
Name:CHRISTENSEN, CARY ANN (CRNFA)
Entity Type:Individual
Prefix:
First Name:CARY
Middle Name:ANN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 670039
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75367
Mailing Address - Country:US
Mailing Address - Phone:214-378-9898
Mailing Address - Fax:214-378-9888
Practice Address - Street 1:2801 LEMMON AVE
Practice Address - Street 2:STE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-220-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654234363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical