Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0024173155 | VA |
NPI | 1043675044 |
---|---|
Provider Name | Kristin Cheatham |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2015 |
Last Update Date | 02/08/2021 |