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Individual

MRS. PEGGY S THURSTON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
410 MAPLE AVE W, 5, VIENNA, VA 22180
(703) 938-2244
(703) 938-3669
Mailing address
10400 EATON PLACE, 410, FAIRFAX, VA 22030
(703) 359-5160
(703) 383-9574

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024164153
VA

Other

Enumeration date
03/17/2006
Last updated
07/08/2007
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