Provider Demographics
NPI:1356892673
Name:CHRISTENSEN, PATRICIA ANN (SP016801)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:SP016801
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SELLERSVILLE DR
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-8317
Mailing Address - Country:US
Mailing Address - Phone:973-945-3158
Mailing Address - Fax:
Practice Address - Street 1:1154A W MAIN ST
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1323
Practice Address - Country:US
Practice Address - Phone:570-424-1235
Practice Address - Fax:570-424-1259
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN612889163W00000X
PASP016801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse