Healthcare Provider Details

I. General information

NPI: 1225858855
Provider Name (Legal Business Name): CRISTINA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIRCLE CASE MANAGEMENT/DISCHARGE PLANNING DEPARTMENT
PORTSMOUTH VA
23708
US

IV. Provider business mailing address

516 COLONEL BYRD ST
CHESAPEAKE VA
23323-1319
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-7500
  • Fax: 757-953-0349
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0001225217
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: