Provider Demographics
NPI:1992888416
Name:CHRISTENSEN, VIRGINIA N (PT, DSC, OCS)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:N
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PT, DSC, OCS
Other - Prefix:MRS
Other - First Name:VIRGINIA
Other - Middle Name:N
Other - Last Name:HIGHLEYMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT DSC OCS
Mailing Address - Street 1:PO BOX 8467
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-8467
Mailing Address - Country:US
Mailing Address - Phone:307-733-5577
Mailing Address - Fax:307-733-5505
Practice Address - Street 1:1090 S HWY 89
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001
Practice Address - Country:US
Practice Address - Phone:307-733-5577
Practice Address - Fax:307-733-5505
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY304295OtherBCBS
WY113733600Medicaid
WY113733600Medicaid