Healthcare Provider Details

I. General information

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

II. Dates (important events)

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

III. Provider practice location address

701 BOULDER SPRINGS DR APT C1
NORTH CHESTERFIELD VA
23225-5523
US

IV. Provider business mailing address

701 BOULDER SPRINGS DR APT C1
NORTH CHESTERFIELD VA
23225-5523
US

V. Phone/Fax

Practice location:
  • Phone: 757-270-8102
  • Fax:
Mailing address:
  • Phone: 757-270-8102
  • 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: