Healthcare Provider Details

I. General information

NPI: 1740191212
Provider Name (Legal Business Name): JENNY CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 N 200 E
NORTH LOGAN UT
84341-1945
US

IV. Provider business mailing address

2898 S 1080 W
NIBLEY UT
84321-6489
US

V. Phone/Fax

Practice location:
  • Phone: 435-753-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: