Provider Demographics
NPI:1306946413
Name:CHRISTIANSEN, MARY ANNE - (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARY ANNE
Middle Name:-
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 JULIA LN
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1564
Mailing Address - Country:US
Mailing Address - Phone:412-331-4852
Mailing Address - Fax:412-749-7497
Practice Address - Street 1:720 BLACKBURN RD
Practice Address - Street 2:HERITAGE VALLEY PHARMACY, SEWICKLEY
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1459
Practice Address - Country:US
Practice Address - Phone:412-749-7329
Practice Address - Fax:412-749-7497
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031883L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist