Provider Demographics
NPI:1013276641
Name:CHRISTENSEN, ALISA-ANN (DO)
Entity type:Individual
Prefix:
First Name:ALISA-ANN
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALISA-ANN
Other - Middle Name:HIILEI
Other - Last Name:HYUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-428-1610
Mailing Address - Fax:859-428-3923
Practice Address - Street 1:520 VIOLET RD
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030
Practice Address - Country:US
Practice Address - Phone:859-428-1610
Practice Address - Fax:859-428-3923
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019772207Q00000X
KY03877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine