Provider Demographics
NPI:1649656976
Name:VOLK, KRISTA L (CSA)
Entity type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:L
Last Name:VOLK
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BOULDER SPRINGS DR
Mailing Address - Street 2:APT C1
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5523
Mailing Address - Country:US
Mailing Address - Phone:757-270-8102
Mailing Address - Fax:
Practice Address - Street 1:701 BOULDER SPRINGS DR
Practice Address - Street 2:APT C1
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-5523
Practice Address - Country:US
Practice Address - Phone:757-270-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant