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General NPI Number Information
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NPI Number | 1194987131
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Entity Type | Individual
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Provider Name | DIANA LYNN CHRISTENSEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 3205 WEST STATE ROAD 45 CHRISTENSEN EYE CARE
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City | BLOOMINGTON
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State | IN
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Zip | 47403
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Country | US
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Telephone | 812-333-8912
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Fax | 812-333-8918
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Provider Business Mailing Address
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Address Line | 3655 S SARE RD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-4173
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Country | US
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Telephone | 812-727-7444
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Fax | 812-727-7445
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18003506A
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License Number State | IN
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