Provider Demographics
NPI:1548081318
Name:ESTLUND, CHRISTY ROWE (HIS)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ROWE
Last Name:ESTLUND
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 UNIVERSITY AVENUE WEST
Mailing Address - Street 2:SUITE 135N
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114
Mailing Address - Country:US
Mailing Address - Phone:651-646-2427
Mailing Address - Fax:651-649-3018
Practice Address - Street 1:2550 UNIVERSITY AVENUE WEST
Practice Address - Street 2:SUITE 135N
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114
Practice Address - Country:US
Practice Address - Phone:651-646-2427
Practice Address - Fax:651-649-3018
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE857237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist