Provider Demographics
NPI:1558232603
Name:WINFREY, CHRISTINA MICHELLE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:WINFREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12417 BRANNER WAY APT 204
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2807
Mailing Address - Country:US
Mailing Address - Phone:804-551-4478
Mailing Address - Fax:804-825-3025
Practice Address - Street 1:12417 BRANNER WAY APT 204
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2807
Practice Address - Country:US
Practice Address - Phone:804-551-4478
Practice Address - Fax:804-825-3025
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator