MEDICARE: DR. CHRISENIA MARIA WHITE ND,LDN, L.AC, DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist	164.007151	IL
2	111N00000X	Chiropractor	0104-557598	VA
3	133NN1002X	Nutrition Education Nutritionist	164.007151	IL
4	171100000X	Acupuncturist	0121-000942	VA
5	175F00000X	Naturopath	ND2200098	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	472557822	OTHER		N/A

General Provider Information

NPI Number	:	1124541313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISENIA MARIA WHITE ND,LDN, L.AC, DC

Provider Business Mailing Address
First Line	:	10560 MAIN ST STE 510
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-7173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10560 MAIN ST STE 510
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-7173
Country	:	US
Telephone Number	:	571-934-1726
Fax Number	:	800-963-5633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2017
Last Update Date	:	04/07/2026

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Directions to “ DR. CHRISENIA MARIA WHITE ND,LDN, L.AC, DC” Practice Location

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