MEDICARE: SHEENA CHRISTIANSEN NP

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
1	363LF0000X	Family Nurse Practitioner	AP5047	AZ

General Provider Information

NPI Number	:	1245662063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEENA CHRISTIANSEN NP

Provider Business Mailing Address
First Line	:	1930 W. THUNDERBIRD RD
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85023
Country	:	US
Telephone Number	:	602-850-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6369
Country	:	US
Telephone Number	:	602-821-6044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	12/31/2014

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