| Doctor Name: | CRYSTON MICHELLE REDIESKE |
| NPI Number: | 1063832384 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 0024171514 |
| Business Practice Address: | 575 Industrial Dr Louisa, VA - 230934146 |
| Business Phone Number: | 5409672011 |
| Business Fax Number: | 5409672982 |
| Mailing Address: | Po Box 9007, CHARLOTTESVILLE |
| State: | VA |
| Postal Code: | 229069007 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2014 |
| NPI Last Update Date: | 01/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024171514 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |