Provider Demographics
NPI:1942464284
Name:CHRISTENSEN, NATHAN RICHARD (OD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:RICHARD
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 E 200 N
Mailing Address - Street 2:
Mailing Address - City:SANTAQUIN
Mailing Address - State:UT
Mailing Address - Zip Code:84655-7048
Mailing Address - Country:US
Mailing Address - Phone:801-657-0320
Mailing Address - Fax:844-221-4750
Practice Address - Street 1:252 W MAIN ST UNIT C
Practice Address - Street 2:
Practice Address - City:SANTAQUIN
Practice Address - State:UT
Practice Address - Zip Code:84655-7250
Practice Address - Country:US
Practice Address - Phone:801-609-2020
Practice Address - Fax:844-221-4750
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7044278-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist