Provider Demographics
NPI:1508462235
Name:HAESSLER, CHRISTINE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:HAESSLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 SAVANNA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-6240
Mailing Address - Country:US
Mailing Address - Phone:540-330-0547
Mailing Address - Fax:
Practice Address - Street 1:FOOD LION PHARMACY #2174
Practice Address - Street 2:14807 MONETA RD
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121
Practice Address - Country:US
Practice Address - Phone:540-297-0927
Practice Address - Fax:540-297-0956
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist