Provider Demographics
NPI:1982234266
Name:CHRISTENSEN, JUDITH JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:JEAN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37950 MAPLEHILL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-2737
Mailing Address - Country:US
Mailing Address - Phone:586-822-6178
Mailing Address - Fax:
Practice Address - Street 1:37950 MAPLEHILL ST
Practice Address - Street 2:
Practice Address - City:HARRISON TWP
Practice Address - State:MI
Practice Address - Zip Code:48045-2737
Practice Address - Country:US
Practice Address - Phone:586-822-6178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-25
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist