1538373816 NPI number — MS. KATHERINE MONICA CHRISTENSEN M.S.

Table of content: MS. KATHERINE MONICA CHRISTENSEN M.S. (NPI 1538373816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538373816 NPI number — MS. KATHERINE MONICA CHRISTENSEN M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTENSEN
Provider First Name:
KATHERINE
Provider Middle Name:
MONICA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
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:
1538373816
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3691 RUTGER ST
Provider Second Line Business Mailing Address:
PROVIDER ENROLLMENT
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63110-2515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-977-6828
Provider Business Mailing Address Fax Number:
314-977-6777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1465 S GRAND BLVD
Provider Second Line Business Practice Location Address:
CARDINAL GLENNON CHILDREN'S MEDICAL CENTER
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63104-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-577-5639
Provider Business Practice Location Address Fax Number:
314-268-4112
Provider Enumeration Date:
05/09/2007

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: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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