Provider Demographics
NPI:1396135414
Name:CHRISTENSEN, AMY DAWN (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:DAWN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:DAWN
Other - Last Name:MCCORMICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:805 SAINT VINCENTS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1638
Mailing Address - Country:US
Mailing Address - Phone:205-939-3699
Mailing Address - Fax:205-581-7155
Practice Address - Street 1:805 SAINT VINCENTS DR STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1638
Practice Address - Country:US
Practice Address - Phone:205-939-3699
Practice Address - Fax:205-581-7155
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALTA. 1791363A00000X
ALPA.1042363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant