Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5280964-4408 | UT |
NPI | 1215173075 |
---|---|
Provider Name | Mary Ann Alexander Christensen |
First Address | South Jordan, UT 84095-7764 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2008 |
Last Update Date | 08/09/2021 |