Provider Demographics
NPI:1972538759
Name:CHRISTENSEN, BECKY SUE (APRN)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:SUE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:SUE
Other - Last Name:USREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:6349 BLUSHING WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-3324
Mailing Address - Country:US
Mailing Address - Phone:702-526-7699
Mailing Address - Fax:702-272-2312
Practice Address - Street 1:6349 BLUSHING WILLOW ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-3324
Practice Address - Country:US
Practice Address - Phone:702-526-7699
Practice Address - Fax:702-272-2312
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2134752363LF0000X
NV001120363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV38549Medicare PIN
NVQ16703Medicare UPIN