Individual
MRS. MAURA ANN CONSTANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10304 EATON PL STE 100, FAIRFAX, VA 22030-2221
(571) 463-8620
(571) 999-7549
Mailing address
203 S LEE ST, FALLS CHURCH, VA 22046-3925
(703) 508-1699
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024164954
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024164954
VA
Other
Enumeration date
10/30/2014
Last updated
02/26/2026
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