Individual
MS. ROSE MUDIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 W BRADDOCK RD, ALEXANDRIA, VA 22304-1099
(703) 379-6000
(703) 671-8897
Mailing address
4400 W BRADDOCK RD, ALEXANDRIA, VA 22304-1010
(703) 379-6000
(703) 671-8897
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
H1871
VA
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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