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General NPI Number Information
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NPI Number | 1346026960
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Entity Type | Individual
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Provider Name | CHRISTINA ELIZABETH O'CONNOR
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Gender | Female
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 100 SENTARA CIR
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5713
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Country | US
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Telephone | 757-984-7270
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Fax |
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Provider Business Mailing Address
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Address Line | 3620 HOLLY FORK RD
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City | BARHAMSVILLE
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State | VA
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Zip | 23011-2141
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Country | US
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Telephone | 757-345-9765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AG08230038
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG08230038
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License Number State | VA
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