Provider Demographics
NPI:1740965086
Name:CHRISTENSEN, CHERILYN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CHERILYN
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:CHERILYN
Other - Middle Name:
Other - Last Name:CRABTREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6622 WILLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN GREEN
Mailing Address - State:UT
Mailing Address - Zip Code:84050-6810
Mailing Address - Country:US
Mailing Address - Phone:801-668-5737
Mailing Address - Fax:
Practice Address - Street 1:415 MEDICAL DR STE B102
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4989
Practice Address - Country:US
Practice Address - Phone:801-683-1062
Practice Address - Fax:801-295-5537
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7122214-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily