Provider Demographics
NPI:1548500689
Name:ANDERSON, CHRISTINE HELEN (RN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:HELEN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9352 SYCAMORE CT N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-7116
Mailing Address - Country:US
Mailing Address - Phone:612-306-4432
Mailing Address - Fax:
Practice Address - Street 1:9352 SYCAMORE CT N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7116
Practice Address - Country:US
Practice Address - Phone:612-306-4432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-205119-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse