Provider Demographics
NPI:1295503787
Name:CHRISTENSEN, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2974 E MAIN RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4232
Mailing Address - Country:US
Mailing Address - Phone:401-293-5790
Mailing Address - Fax:401-293-5796
Practice Address - Street 1:2974 E MAIN RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4232
Practice Address - Country:US
Practice Address - Phone:401-293-5790
Practice Address - Fax:401-293-5796
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker