1467544197 NPI number — MS. MARILYN JOY CHRISTENSEN LLP

Table of content: MS. MARILYN JOY CHRISTENSEN LLP (NPI 1467544197)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467544197 NPI number — MS. MARILYN JOY CHRISTENSEN LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTENSEN
Provider First Name:
MARILYN
Provider Middle Name:
JOY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LLP
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:
MARILYN
Provider Other Middle Name:
REED
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LLP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1467544197
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 N KALAMAZOO AVE
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
PAW PAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49079-1321
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-655-6740
Provider Business Mailing Address Fax Number:
269-655-2950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 N KALAMAZOO AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
PAW PAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49079-1321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-655-6740
Provider Business Practice Location Address Fax Number:
269-655-2950
Provider Enumeration Date:
09/29/2006

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:  6301007947 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 098509 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".




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