# MARY JUNE C SO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1609258946
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 0001220246 | VA | — |
| 163W00000X | Registered Nurse | 1017196 | DC | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 0024172718 | VA | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AC002763 | MD | — |

## Other

- **Enumeration date:** 06/23/2015
- **Last updated:** 08/31/2023