Provider Demographics
NPI:1962624072
Name:WARNIMENT, CRISTA B (MD)
Entity type:Individual
Prefix:
First Name:CRISTA
Middle Name:B
Last Name:WARNIMENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WARRIOR DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4044
Mailing Address - Country:US
Mailing Address - Phone:540-868-4100
Mailing Address - Fax:540-868-0888
Practice Address - Street 1:160 WARRIOR DR
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-4044
Practice Address - Country:US
Practice Address - Phone:540-868-4100
Practice Address - Fax:540-868-0888
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116017599390200000X
VA0101243812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1962624072Medicaid
MC10431OtherMEDICARE PTAN