Provider Demographics
NPI:1942426119
Name:CHRISTENSON, DORANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:DORANNA
Middle Name:
Last Name:CHRISTENSON
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 1:8890 N UNION BLVD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7799
Mailing Address - Country:US
Mailing Address - Phone:719-282-4206
Mailing Address - Fax:719-282-4209
Practice Address - Street 1:8210 SAINT HELENA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4603
Practice Address - Country:US
Practice Address - Phone:719-314-7779
Practice Address - Fax:719-282-4209
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41422207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO41169OtherMEDICARE PTAN
CO05102383Medicaid
CO55657851Medicaid
COCO41169OtherMEDICARE PTAN