Individual
CARISSA LYNN PARDEKOOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2117 GENERAL BOOTH BLVD, VIRGINIA BEACH, VA 23454-5803
(757) 689-8183
Mailing address
2117 GENERAL BOOTH BLVD, VIRGINIA BEACH, VA 23454-5803
(757) 689-8183
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008037
VA
363A00000X
Physician Assistant
081387
—
363A00000X
Physician Assistant
085005227
IL
Other
Enumeration date
10/06/2014
Last updated
07/18/2025
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