MEDICARE: MS. BECKY SUE CHRISTENSEN APRN

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	2134752	FL
2	363LF0000X	Family Nurse Practitioner	001120	NV

General Provider Information

NPI Number	:	1972538759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BECKY SUE CHRISTENSEN APRN

Provider Business Mailing Address
First Line	:	6349 BLUSHING WILLOW ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3324
Country	:	US
Telephone Number	:	702-526-7699
Fax Number	:	702-272-2312

Provider Business Practice Location Address
First Line	:	6349 BLUSHING WILLOW ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3324
Country	:	US
Telephone Number	:	702-526-7699
Fax Number	:	702-272-2312

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/23/2014

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