1841390382 NPI number — DR. DAWN ERIN CHRISTENSEN PSYD

Table of content: KEITH ROCKINS IDMT (NPI 1801030903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841390382 NPI number — DR. DAWN ERIN CHRISTENSEN PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTENSEN
Provider First Name:
DAWN
Provider Middle Name:
ERIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHRISTENSEN
Provider Other First Name:
D. ERIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSY.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1841390382
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 625
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVENPORT
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33836-0625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-344-1819
Provider Business Mailing Address Fax Number:
863-353-6081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410 LAKE DAVENPORT CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33837-7530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-344-1819
Provider Business Practice Location Address Fax Number:
863-353-6081
Provider Enumeration Date:
09/24/2006

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: 103T00000X , with the licence number:  847 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 06Y008613NH01 . This is a "NH BC/BS PROVIDER ID" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30423735 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112225800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com