Provider Demographics
NPI:1992146534
Name:TALAIVER, CHRISTEN E (NP)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:E
Last Name:TALAIVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1460
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-1460
Mailing Address - Country:US
Mailing Address - Phone:540-785-7810
Mailing Address - Fax:540-786-3099
Practice Address - Street 1:7967 KINGS HWY
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-7075
Practice Address - Country:US
Practice Address - Phone:540-775-6445
Practice Address - Fax:540-775-6449
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1992146534Medicaid
VA1992146534Medicare PIN