Provider Demographics
NPI:1366316457
Name:CHRISTENSEN, STEPHANIE SUE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SUE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W PARADISE LK
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:NE
Mailing Address - Zip Code:68865-1700
Mailing Address - Country:US
Mailing Address - Phone:308-382-3660
Mailing Address - Fax:308-395-3214
Practice Address - Street 1:2201 N BROADWELL AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2196
Practice Address - Country:US
Practice Address - Phone:308-382-3660
Practice Address - Fax:308-395-3214
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE73817163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse