Healthcare Provider Details

I. General information

NPI: 1780929513
Provider Name (Legal Business Name): CHRISTON PAIGE STILTNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CHRISTON PAIGE PRATER

II. Dates (important events)

Enumeration Date: 12/05/2012
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 MEDICAL CENTER BOULEVARD
HAYSI VA
24256-2599
US

IV. Provider business mailing address

162 MEDICAL CENTER BOULEVARD
HAYSI VA
24256-2599
US

V. Phone/Fax

Practice location:
  • Phone: 276-865-5121
  • Fax: 276-546-9707
Mailing address:
  • Phone: 276-865-5121
  • Fax: 276-546-9707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170508
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: