Provider Demographics
NPI:1871570184
Name:CHRISTENSEN, NANCY CAROLINE (PT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:CAROLINE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:CAROLINE
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 FOXTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9360
Mailing Address - Country:US
Mailing Address - Phone:970-674-6514
Mailing Address - Fax:970-674-6598
Practice Address - Street 1:1605 FOXTRAIL DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9360
Practice Address - Country:US
Practice Address - Phone:970-674-6514
Practice Address - Fax:970-674-6598
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRPT1696225100000X
WAPT00008777225100000X
CO6691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8398083Medicaid
CO43227716Medicaid
CO426529YLB8Medicare PIN