Individual
DR. CANDACE CHRISTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1212 SANDY LN, MONTICELLO, MN 55362-8968
(612) 310-2203
Mailing address
1212 SANDY LN, MONTICELLO, MN 55362-8968
(612) 310-2203
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2960
MN
152W00000X
Optometrist
3269
CT
152W00000X
Optometrist
3498-35
WI
152W00000X
Optometrist
TA2880
MD
152W00000X
Optometrist
TPOP48
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-04249
MEDICA, MACY'S LOCATION
MN
01
—
22-04250
MEDICA, JCP LOCATION
MN
01
—
221006
EYEMED
MN
01
—
2960
LICENSE
MN
01
—
3498-35
LICENSE
WI
01
—
538K5CH
BCBS OF MN
MN
05
—
560-131-200
—
MN
01
—
MN2960
STATE LICENSE
MN
01
—
TPOP48
STATE LICENSE
FL
Enumeration date
02/05/2007
Last updated
03/06/2023
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