Individual
COLLEEN CHRISTIANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3 RICHLAND MEDICAL PARK DR STE 310, COLUMBIA, SC 29203-6862
(803) 434-8323
(803) 434-8326
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3722
SC
363AS0400X
Surgical Physician Assistant
004830
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
05/01/2008
Last updated
07/26/2021
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