Individual
PREVITHA SANNA MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 391-3600
Mailing address
7851 WINTERCRESS LN, SPRINGFIELD, VA 22152-3843
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024175885
VA
390200000X
Student in an Organized Health Care Education/Training Program
1271698
VA
Other
Enumeration date
11/21/2017
Last updated
11/06/2019
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