1588435333 NPI number — JENNA CHRISTENSEN PCLC

Table of content: DR. LORNA SMINK TIMMRECK M.D. (NPI 1710972526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588435333 NPI number — JENNA CHRISTENSEN PCLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTENSEN
Provider First Name:
JENNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PCLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588435333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6132 ELYSIAN RD UNIT 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BILLINGS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59101-7091
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-861-2998
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1018 N 30TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59101-0732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-252-4194
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  BBH-PCLC-LIC-69921 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)