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Individual

MARY JOSEPH FRICKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
1800 TOWN CENTER DRIVE, SUITE 220, RESTON, VA 20190-3238
(703) 435-2555
(571) 926-8910
Mailing address
224-D CORNWALL ST., NW SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024121397
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053556175
VA
05
30015909410002
VA
Enumeration date
12/03/2008
Last updated
03/06/2024
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