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NPI Code Detail

MEDICARE: REBECCA LYN CHRISTENSEN MD

MEDICARE:   REBECCA LYN CHRISTENSEN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician41615KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13547360000OTHERKYPASSPORT ADVANTAGE
250021034OTHERKYPASSPORT HEALTH PLAN
3000000564414OTHERKYANTHEM BLUE CROSS AND BLUE SHEILD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093718447
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LYN CHRISTENSEN MD
Provider Business Mailing Address
First Line : 2307 GREENE WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-4009
Country : US
Telephone Number : 502-736-4343
Fax Number :
Provider Business Practice Location Address
First Line : 2307 GREENE WAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-4009
Country : US
Telephone Number : 502-897-9594
Fax Number : 502-896-1808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 02/21/2017

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Directions to “ REBECCA LYN CHRISTENSEN MD” Practice Location

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