MEDICARE: MS. CHRISTINA LO BIRDSONG CD(DONA)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1073883989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA LO BIRDSONG CD(DONA)

Provider Business Mailing Address
First Line	:	7426 N SHORE RD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-1756
Country	:	US
Telephone Number	:	757-490-3633
Fax Number	:

Provider Business Practice Location Address
First Line	:	7426 N SHORE RD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-1756
Country	:	US
Telephone Number	:	757-490-3633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2012
Last Update Date	:	01/09/2012

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