Provider Demographics
NPI:1477237642
Name:SUMNER, CHRISTEN
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:SUMNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6243 HIDDEN CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1130
Mailing Address - Country:US
Mailing Address - Phone:445-787-2885
Mailing Address - Fax:
Practice Address - Street 1:6243 HIDDEN CANYON RD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1130
Practice Address - Country:US
Practice Address - Phone:445-787-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist