Provider Demographics
NPI:1437269438
Name:CHRISTENSEN, PATRICIA ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-3625
Mailing Address - Country:US
Mailing Address - Phone:609-693-9240
Mailing Address - Fax:609-693-3616
Practice Address - Street 1:138 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-3625
Practice Address - Country:US
Practice Address - Phone:609-693-9240
Practice Address - Fax:609-693-3616
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN96160363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00312516OtherRR MEDICARE PROV #
NJDE7355OtherRR MEDICARE GROUP #
NJS63788Medicare UPIN
NJ062087Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJDE7355OtherRR MEDICARE GROUP #