Provider Demographics
NPI:1356844427
Name:MATTHEWS, KRISTINA MARIA (CNA, MA, QMHP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIA
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:CNA, MA, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 LASKIN ROAD
Mailing Address - Street 2:SUITE 140-G
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451
Mailing Address - Country:US
Mailing Address - Phone:757-807-7246
Mailing Address - Fax:757-807-7248
Practice Address - Street 1:1206 LASKIN ROAD
Practice Address - Street 2:SUITE 140-G
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451
Practice Address - Country:US
Practice Address - Phone:757-807-7246
Practice Address - Fax:757-807-7248
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide