Provider Demographics
NPI:1285869727
Name:CHRISTENSEN, STEPHANI DAWN (MD)
Entity type:Individual
Prefix:
First Name:STEPHANI
Middle Name:DAWN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 N STEPHANIE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6692
Mailing Address - Country:US
Mailing Address - Phone:702-952-3350
Mailing Address - Fax:702-952-3365
Practice Address - Street 1:1505 WIGWAM PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8195
Practice Address - Country:US
Practice Address - Phone:702-856-1400
Practice Address - Fax:702-856-1407
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15837207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1285869727Medicaid
NVV50868OtherMEDICARE PTAN