Provider Demographics
NPI:1407936040
Name:CHRISTENSEN, CATHERINE A (RN, WHCNP, CNM)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RN, WHCNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:61361-0014
Mailing Address - Country:US
Mailing Address - Phone:815-343-0771
Mailing Address - Fax:
Practice Address - Street 1:2220 MARQUETTE RD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1555
Practice Address - Country:US
Practice Address - Phone:815-343-0771
Practice Address - Fax:888-303-1960
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-263443363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILMC0838978OtherIL DEA