MEDICARE: CHRISTINE TERRY-WARREN

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	172A00000X	Driver	1945	VA
2	171W00000X	Contractor	1945	VA

General Provider Information

NPI Number	:	1932047875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE TERRY-WARREN

Provider Business Mailing Address
First Line	:	1526 BERRY HILL RD
Second Line	:
City	:	SOUTH BOSTON
State	:	VA
Zip	:	24592-6216
Country	:	US
Telephone Number	:	434-233-4407
Fax Number	:

Provider Business Practice Location Address
First Line	:	1526 BERRY HILL RD
Second Line	:
City	:	SOUTH BOSTON
State	:	VA
Zip	:	24592-6216
Country	:	US
Telephone Number	:	434-233-4407
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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