Provider Demographics
NPI:1356932719
Name:CHRISTENSEN, KATHRYN ELIZABETH (CNM, WHNP)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619-0504
Mailing Address - Country:US
Mailing Address - Phone:916-832-9218
Mailing Address - Fax:
Practice Address - Street 1:1095 MARSHALL WAY STE 201
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5722
Practice Address - Country:US
Practice Address - Phone:530-344-5470
Practice Address - Fax:530-748-0323
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA236188367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife