Provider Demographics
NPI:1194385070
Name:WHITT, CRISTINA MAY (FNP)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MAY
Last Name:WHITT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BROOKE ELYSE LN
Mailing Address - Street 2:
Mailing Address - City:MAX MEADOWS
Mailing Address - State:VA
Mailing Address - Zip Code:24360-3547
Mailing Address - Country:US
Mailing Address - Phone:276-245-5663
Mailing Address - Fax:
Practice Address - Street 1:101 1ST ST NW
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-5605
Practice Address - Country:US
Practice Address - Phone:540-980-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAF04190587363LP2300X
VA0024178125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF04190587OtherFAMILY NURSE PRACTITIONER LICENSE NUMBER