Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0104-557598 | VA |
Y | 111N00000X | Chiropractor | 038013231 | IL |
N | 175F00000X | Naturopath | NP-0098 | DC |
NPI | 1124541313 |
---|---|
Provider Name | Dr. Chrisenia Maria White |
First Address | Dulles, VA 20166-2650 |
Second Address | Fairfax, VA 22030-7175 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2017 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
472557822 | N/A (01) |