| NPI | 1083014385 |
|---|---|
| Former Name | DANETTE LEE CHRISTIANSON |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R-104601-4) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2016-01-07 |