Provider Demographics
NPI:1942517883
Name:CHRISTIANSEN, MICHAEL JAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAY
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BRADLEY SQ
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-1606
Mailing Address - Country:US
Mailing Address - Phone:702-545-5347
Mailing Address - Fax:
Practice Address - Street 1:12645 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-4803
Practice Address - Country:US
Practice Address - Phone:775-853-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program