Healthcare Provider Details

I. General information

NPI: 1568727550
Provider Name (Legal Business Name): CRISTINA RUZILA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 COX RD STE 285
GLEN ALLEN VA
23060-6808
US

IV. Provider business mailing address

PO BOX 1595
MIDDLETOWN CT
06457-8095
US

V. Phone/Fax

Practice location:
  • Phone: 703-834-1473
  • Fax: 703-318-7463
Mailing address:
  • Phone: 860-788-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0001198243
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: