Breshae Christofferson

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

10195986-2402 Issued in UT

Practice address

630 E 1400 N Ste 140
Logan, UT 84341-2549

Phone

(435) 213-3850

NPI assigned

Apr 13, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1225525421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 CANYON RIDGE DR",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843418314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E 1400 N STE 140",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412549",
            "telephone_number": "435-213-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOFFERSON",
        "first_name": "BRESHAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "10195986-2402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Christensen, MD
• Tina Christensen
• Tyler Christensen, PH.D.
• Christian D Nilson MD PC
• David E Christian, PHD
• Brian D Chudleigh, DMD
• Mary Danelle Chugg
• Emmalee Clark, OTR
• Lapriel Clark
• Derrel W Clarke, MD

• Physical Therapy Assistant in Logan, UT
• Providers in Logan, UT by specialty
• Physical Therapy Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.