Healthcare Provider Details

I. General information

NPI: 1558106781
Provider Name (Legal Business Name): RHETT DOUGLAS CHRISTENSEN DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 CAPITOL BLVD
SAINT PAUL MN
55103-2101
US

IV. Provider business mailing address

145 2ND AVE SE
CAMBRIDGE MN
55008-1602
US

V. Phone/Fax

Practice location:
  • Phone: 651-235-7198
  • Fax:
Mailing address:
  • Phone: 320-496-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11725
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: