MEDICARE: DR. CHRISTINE ANN NELSON PH.D.

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	103TC0700X	Clinical Psychologist	0810003704	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	239362	OTHER	VA	ANTHEM BLUE CROSS& SHIELD

General Provider Information

NPI Number	:	1629130331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE ANN NELSON PH.D.

Provider Business Mailing Address
First Line	:	9020 STONY POINT PARKWAY
Second Line	:	SUITE 375
City	:	RICHMOND
State	:	VA
Zip	:	23235
Country	:	US
Telephone Number	:	804-728-2190
Fax Number	:

Provider Business Practice Location Address
First Line	:	9020 STONY POINT PKWY STE 375
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-1946
Country	:	US
Telephone Number	:	804-728-2190
Fax Number	:

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

Provider Enumeration Date	:	12/16/2006
Last Update Date	:	07/21/2022

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