Provider Demographics
NPI:1821262551
Name:CARDONE, CHRISTINE LORI (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LORI
Last Name:CARDONE
Suffix:
Gender:F
Credentials:FNP-BC
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:703-361-5116
Mailing Address - Fax:703-361-5876
Practice Address - Street 1:10945 GEORGE MASON CIR STE 105
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-2234
Practice Address - Country:US
Practice Address - Phone:703-361-5116
Practice Address - Fax:571-364-8911
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171649363L00000X
TNAPN0000012992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVG244AMedicare PIN