Provider Demographics
NPI:1467125278
Name:WAHL, CHRISTEN (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:WAHL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTEN
Other - Middle Name:
Other - Last Name:SHERRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:1602 N FARES AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-3952
Mailing Address - Country:US
Mailing Address - Phone:812-437-3784
Mailing Address - Fax:812-437-7155
Practice Address - Street 1:1602 N FARES AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-3952
Practice Address - Country:US
Practice Address - Phone:812-437-3784
Practice Address - Fax:812-437-7155
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300074277Medicaid
KY7100764650Medicaid