Healthcare Provider Details

I. General information

NPI: 1720717788
Provider Name (Legal Business Name): CRISTINA ESPINOSA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W CRISER RD
FRONT ROYAL VA
22630-2360
US

IV. Provider business mailing address

1200 N HERNDON ST APT 336
ARLINGTON VA
22201-7023
US

V. Phone/Fax

Practice location:
  • Phone: 540-636-4250
  • Fax:
Mailing address:
  • Phone: 610-297-6925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024184183
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: