Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024175938 | VA |
NPI | 1023340775 |
---|---|
Provider Name | Dr. Christine Mazimba |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2010 |
Last Update Date | 29/07/2021 |