Provider Demographics
NPI:1134544463
Name:CHRISTIAN, JENNIFER N (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:N
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 PASEO DEL PUEBLO NORTE
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6373
Mailing Address - Country:US
Mailing Address - Phone:575-758-8498
Mailing Address - Fax:575-751-7337
Practice Address - Street 1:813 PASEO DEL PUEBLO NORTE
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6373
Practice Address - Country:US
Practice Address - Phone:575-758-8498
Practice Address - Fax:575-751-7337
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor