Healthcare Provider Details

I. General information

NPI: 1689481277
Provider Name (Legal Business Name): SYDNEY CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 N 30TH ST # 100
OMAHA NE
68111-3701
US

IV. Provider business mailing address

2120 N 30TH ST # 100
OMAHA NE
68111-3701
US

V. Phone/Fax

Practice location:
  • Phone: 402-451-3130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number1842
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: