Healthcare Provider Details

I. General information

NPI: 1437433620
Provider Name (Legal Business Name): AMY LOUISE CHRISTIANSEN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 BARTLETT ST ATTN:A. CHRISTIANSEN RN @COMMUNITY HEALTH SERVICES
HOMER AK
99603-7005
US

IV. Provider business mailing address

4300 BARTLETT ST
HOMER AK
99603-7005
US

V. Phone/Fax

Practice location:
  • Phone: 907-235-0306
  • Fax: 907-235-0810
Mailing address:
  • Phone: 907-235-0306
  • Fax: 907-235-0810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2472V0600X
TaxonomyVeterinary Technician
License NumberVET T 46
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR R 28534
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: