Provider Demographics
NPI:1013698992
Name:CHRISTENSEN, DEVIN W (PA-S2)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:W
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:PA-S2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6703
Mailing Address - Country:US
Mailing Address - Phone:801-616-2053
Mailing Address - Fax:
Practice Address - Street 1:1360 S 760 W
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-5578
Practice Address - Country:US
Practice Address - Phone:801-471-7998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant