Individual
TRACI ANNETTA MARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
14701 LEE HWY, SUITE 304, CENTREVILLE, VA 20121-2137
(703) 830-4388
(703) 830-4188
Mailing address
14701 ROUTE 29 STE 304, CENTREVILLE, VA 20121-2135
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
0024169463
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053692343
—
VA
05
—
30016037770003
—
VA
Enumeration date
08/31/2011
Last updated
02/01/2026
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