Provider Demographics
NPI:1538332846
Name:LAURIA, KRISTINE MARIE (CPM)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:LAURIA
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8247 FORT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FORT VALLEY
Mailing Address - State:VA
Mailing Address - Zip Code:22652-2013
Mailing Address - Country:US
Mailing Address - Phone:540-933-6934
Mailing Address - Fax:
Practice Address - Street 1:8247 FORT VALLEY RD
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:VA
Practice Address - Zip Code:22652-2013
Practice Address - Country:US
Practice Address - Phone:540-933-6934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000030176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife