Healthcare Provider Details

I. General information

NPI: 1831211242
Provider Name (Legal Business Name): FAITH A CHRISTENSEN N.D., RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH A TAKAKURA N.D, R.N

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 PARK AVE
MANITOU SPRINGS CO
80829-1747
US

IV. Provider business mailing address

56 PARK AVE
MANITOU SPRINGS CO
80829-1747
US

V. Phone/Fax

Practice location:
  • Phone: 719-651-4383
  • Fax:
Mailing address:
  • Phone: 719-651-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT 1072
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: