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Individual

MRS. SUSAN G MAGENHEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
19455 DEERFIELD AVENUE, SUITE 204, LEESBURG, VA 20176-8102
(703) 858-1500
(703) 858-5022
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
0024165070
VA
367A00000X
Advanced Practice Midwife
RN1022120
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154614048
VA
05
30016809680001
VA
Enumeration date
05/25/2011
Last updated
10/31/2023
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