Provider Demographics
NPI:1528561826
Name:CHRISTENSON, LORNA K
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:K
Last Name:CHRISTENSON
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:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:KESWICK
Mailing Address - State:VA
Mailing Address - Zip Code:22947-0024
Mailing Address - Country:US
Mailing Address - Phone:434-295-0457
Mailing Address - Fax:
Practice Address - Street 1:500 LITTLE KESWICK LN
Practice Address - Street 2:
Practice Address - City:KESWICK
Practice Address - State:VA
Practice Address - Zip Code:22947-2406
Practice Address - Country:US
Practice Address - Phone:434-295-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000831225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0119000831OtherBOARD OF MEDICINE