Provider Demographics
NPI:1033354717
Name:CHRISTENSEN, BRIAN (FNP)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1147
Mailing Address - Country:US
Mailing Address - Phone:801-798-2515
Mailing Address - Fax:801-798-2510
Practice Address - Street 1:750 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1147
Practice Address - Country:US
Practice Address - Phone:801-798-2515
Practice Address - Fax:801-798-2510
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTPENDING363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily