Healthcare Provider Details

I. General information

NPI: 1851215669
Provider Name (Legal Business Name): INDIA MICHELLE CRITZER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARTHA JEFFERSON DR
CHARLOTTESVILLE VA
22911-4668
US

IV. Provider business mailing address

1007 SPRING HILL RD
STAUNTON VA
24401-2025
US

V. Phone/Fax

Practice location:
  • Phone: 434-654-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number0136000384
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: