Provider Demographics
NPI:1386282911
Name:CHRISTENSEN, LYNN (CLC, LCCE, CD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:CLC, LCCE, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 NEWCOMB RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1516
Mailing Address - Country:US
Mailing Address - Phone:201-541-5616
Mailing Address - Fax:
Practice Address - Street 1:134 NEWCOMB RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1516
Practice Address - Country:US
Practice Address - Phone:201-541-5616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
65996174400000X
ALPP-203943174N00000X
2550374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174400000XOther Service ProvidersSpecialist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN