Provider Demographics
NPI:1952597254
Name:SAMPSON, KRISTIN LEIGH (MSED, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEIGH
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:MSED, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 E STONY HILL CT
Mailing Address - Street 2:APT. 1A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6844
Mailing Address - Country:US
Mailing Address - Phone:757-470-7179
Mailing Address - Fax:
Practice Address - Street 1:500 HIOAKS RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4061
Practice Address - Country:US
Practice Address - Phone:804-560-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260010012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer