Provider Demographics
NPI:1679540231
Name:GRABILL, KRISTIN H (PA C)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:H
Last Name:GRABILL
Suffix:
Gender:F
Credentials:PA C
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Mailing Address - Street 1:633 BATTLEFIELD BLVD S
Mailing Address - Street 2:STE 300
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4800
Mailing Address - Country:US
Mailing Address - Phone:757-233-4700
Mailing Address - Fax:757-233-4701
Practice Address - Street 1:1380 TUSCANY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456
Practice Address - Country:US
Practice Address - Phone:767-301-9220
Practice Address - Fax:757-301-9214
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2017-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110001726363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010140285Medicaid
003044S33Medicare ID - Type Unspecified
VA010140285Medicaid