Individual provider Active NPI

Sue Ann R Christensen, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Provo, UT
National Provider Identifier
1851504393
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
216783-4405 Issued in UT
Practice address
1055 N 300 W
Suite 410
Provo, UT 84604-3344
Phone
(801) 357-7883
Fax
(801) 357-7975
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 216783-4405 UT Primary

Addresses

Primary practice location

1055 N 300 W
Suite 410
Provo, UT 84604-3344

Mailing address

1055 N 300 W Ste 410
Provo, UT 84604-3354
Phone (801) 357-7883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
216783-4405UTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Valley Pediatrics L.L.C. Past Accepting new patients
Utah Valley Pediatrics L.L.C. PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1851504393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 410",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043354",
            "telephone_number": "801-357-7883",
            "fax_number": "801-357-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 410",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7883",
            "fax_number": "801-357-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "SUE ANN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "UT",
            "license": "216783-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.