Provider Demographics
NPI:1306884275
Name:FLORY, CHRISTINA GRETCHEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:GRETCHEN
Last Name:FLORY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1802 WESTGATE CIR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2091
Mailing Address - Country:US
Mailing Address - Phone:804-675-5542
Mailing Address - Fax:804-675-5509
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:PRIMARY CARE GROUP PRACTICE B/YELLOW CLINIC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249
Practice Address - Country:US
Practice Address - Phone:804-675-5542
Practice Address - Fax:804-675-5509
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1012637OtherNCCPA CERTIFICATE NUMBER