Healthcare Provider Details

I. General information

NPI: 1548109903
Provider Name (Legal Business Name): MRS. KATRINA RENEE CHRISTIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

843 HENNING ST
DUNDEE MI
48131-1286
US

IV. Provider business mailing address

843 HENNING ST
DUNDEE MI
48131-1286
US

V. Phone/Fax

Practice location:
  • Phone: 410-509-5453
  • Fax:
Mailing address:
  • Phone: 419-509-5453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704240594
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: