Provider Demographics
NPI:1124328000
Name:CHRISTENSEN, CATHY MARGARET (NP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:MARGARET
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 SHELBY AVE
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3849
Mailing Address - Country:US
Mailing Address - Phone:734-448-0226
Mailing Address - Fax:734-212-2121
Practice Address - Street 1:2370 LEFORGE RD
Practice Address - Street 2:
Practice Address - City:SUPERIOR TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48198-9638
Practice Address - Country:US
Practice Address - Phone:734-448-0226
Practice Address - Fax:734-448-0226
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704212754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily