Provider Demographics
NPI:1730077090
Name:JUNIPER, CHRISTIAN (CHRISTIAN)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:JUNIPER
Suffix:
Gender:M
Credentials:CHRISTIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 42ND ST S APT 106A
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6968
Mailing Address - Country:US
Mailing Address - Phone:701-219-3187
Mailing Address - Fax:701-219-3187
Practice Address - Street 1:3420 42ND ST S APT 106A
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-6968
Practice Address - Country:US
Practice Address - Phone:701-219-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND82436376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide