Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 4704218415 | MI |
NPI | 1649208786 |
---|---|
Provider Name | Sonya L Christensen |
First Address | Saint Joseph, MI 49085-3421 |
Second Address | Saint Joseph, MI 49085-3421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 02/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1831186311 | (05) | MI |
P54786 | (02) |