Provider Demographics
NPI:1689717894
Name:MASON, CHRISTINE (DNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:NARAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MN
Mailing Address - Street 1:4379 RIDGEWOOD CENTER DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8322
Mailing Address - Country:US
Mailing Address - Phone:703-680-7950
Mailing Address - Fax:703-680-7053
Practice Address - Street 1:4379 RIDGEWOOD CENTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8322
Practice Address - Country:US
Practice Address - Phone:703-680-7950
Practice Address - Fax:703-680-7053
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00171139928363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics