1326363235 NPI number — MS. CHRISTINA HENDERSON PAXSON L.AC., DIPL.AC.

Table of content: LOIS A GOLDSMITH (NPI 1407867526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326363235 NPI number — MS. CHRISTINA HENDERSON PAXSON L.AC., DIPL.AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAXSON
Provider First Name:
CHRISTINA
Provider Middle Name:
HENDERSON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.AC., DIPL.AC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HENDERSON
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DIPL.AC, L.AC.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326363235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1342 N BOSTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22974-4311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-591-1180
Provider Business Mailing Address Fax Number:
434-591-1180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1342 N BOSTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22974-4311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-591-1180
Provider Business Practice Location Address Fax Number:
434-591-1180
Provider Enumeration Date:
04/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  0121000211 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0121000211 . This is a "VIRGINIA BOARD OF MEDICINE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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