Provider Demographics
NPI:1316236540
Name:CHRISTENSEN AUDIOLOGY AND HEARING AID CENTER
Entity type:Organization
Organization Name:CHRISTENSEN AUDIOLOGY AND HEARING AID CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:402-489-3450
Mailing Address - Street 1:6140 VILLAGE DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3521
Mailing Address - Country:US
Mailing Address - Phone:402-489-3450
Mailing Address - Fax:402-489-3452
Practice Address - Street 1:6140 VILLAGE DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3521
Practice Address - Country:US
Practice Address - Phone:402-489-3450
Practice Address - Fax:402-489-3452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE172237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025271-00Medicaid
NE10025735-00Medicaid