Provider Demographics
NPI:1487380150
Name:CHRISTEN, LISA RENEE (DNP, A-GNP-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:CHRISTEN
Suffix:
Gender:F
Credentials:DNP, A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N BENT ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2712
Mailing Address - Country:US
Mailing Address - Phone:307-764-4107
Mailing Address - Fax:307-764-1879
Practice Address - Street 1:128 N BENT ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2712
Practice Address - Country:US
Practice Address - Phone:307-764-4107
Practice Address - Fax:307-764-1879
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114273363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care