Provider Demographics
NPI:1720458136
Name:CHRISTIANSON, CARRIE LYNN
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:CHRISTIANSON
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 1:4843 NIAGARA AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-6106
Mailing Address - Country:US
Mailing Address - Phone:760-521-2781
Mailing Address - Fax:
Practice Address - Street 1:4843 NIAGARA AVE APT 6
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-6106
Practice Address - Country:US
Practice Address - Phone:760-521-2781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula