MEDICARE: MS. DENA J CHRISTIANSON ARNP

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	363LF0000X	Family Nurse Practitioner	2151582	FL

General Provider Information

NPI Number	:	1659603389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENA J CHRISTIANSON ARNP

Provider Business Mailing Address
First Line	:	4970 SW 167 AVE
Second Line	:
City	:	SOUTHWEST RANCHES
State	:	FL
Zip	:	33331
Country	:	US
Telephone Number	:	954-252-9459
Fax Number	:

Provider Business Practice Location Address
First Line	:	12184 SW 52ND CT
Second Line	:
City	:	COOPER CITY
State	:	FL
Zip	:	33330-4282
Country	:	US
Telephone Number	:	954-252-9459
Fax Number	:

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

Provider Enumeration Date	:	02/05/2010
Last Update Date	:	11/15/2012

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