MEDICARE: MS. JESSICA LINNEY CHRISTIANSEN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1330	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578590493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA LINNEY CHRISTIANSEN DC

Provider Business Mailing Address
First Line	:	5104 S 108TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-2360
Country	:	US
Telephone Number	:	402-933-6208
Fax Number	:	402-933-6170

Provider Business Practice Location Address
First Line	:	5104 S 108TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-2360
Country	:	US
Telephone Number	:	402-933-6208
Fax Number	:	402-933-6170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	07/20/2011

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