Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 8339822-4405 | UT |
N | 363LA2100X | Nurse Practitioner - Acute Care | AP4660 | AZ |
NPI | 1003162215 |
---|---|
Provider Name | Michael Christensen |
First Address | Murray, UT 84121-1644 |
Second Address | Murray, UT 84121-1644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2012 |
Last Update Date | 01/06/2020 |