Provider Demographics
NPI:1881640662
Name:CHRISTENSEN, TAWNI J (MD)
Entity Type:Individual
Prefix:DR
First Name:TAWNI
Middle Name:J
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N GREEN VALLEY PKWY # 440-493
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6163
Mailing Address - Country:US
Mailing Address - Phone:702-906-0027
Mailing Address - Fax:702-906-0160
Practice Address - Street 1:5495 S RAINBOW BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1873
Practice Address - Country:US
Practice Address - Phone:702-906-0027
Practice Address - Fax:702-906-0160
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10154207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV10154OtherMD LICENSEN
G69632Medicare UPIN