Individual
TARA ANN CRISINATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 287-7836
(804) 281-8557
Mailing address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 287-7836
(804) 281-8557
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024167527
VA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
0015000839
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
03/23/2010
Last updated
03/27/2012
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