Individual
THERESA CHRISTOPHERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4375 FAIR LAKES CT, FAIRFAX, VA 22033-4234
(571) 432-2654
Mailing address
13088 MONICA CT, FAIRFAX, VA 22030-8266
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0001313552
VA
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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