Healthcare Provider Details

I. General information

NPI: 1649656976
Provider Name (Legal Business Name): KRISTA L. THORNTON CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTA LOUISE VOLK CSA

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3300
US

IV. Provider business mailing address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3300
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-2552
  • Fax:
Mailing address:
  • Phone: 703-776-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: