MEDICARE: VERONICA KATHERINE CRIST PA-C

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	363A00000X	Physician Assistant	1875	WV

General Provider Information

NPI Number	:	1306905476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA KATHERINE CRIST PA-C

Provider Business Mailing Address
First Line	:	532 PEA RIDGE RD
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-9421
Country	:	US
Telephone Number	:	402-316-8274
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 MAIN ST W
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-3414
Country	:	US
Telephone Number	:	304-469-8600
Fax Number	:

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/07/2022

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