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Individual

MICHELLE A ROSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
8613 LEE HWY # 200N, FAIRFAX, VA 22031-2171
(703) 280-5390
(703) 280-9596
Mailing address
3040 WILLIAMS DR STE 100, FAIRFAX, VA 22031-4618
(571) 350-8400
(703) 940-8746

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001265247
VA
363LF0000X
Family Nurse Practitioner
Primary
0024176307
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001265247
RN LICENSE
VA
01
0024176307
NP LICENSE
VA
05
1184117376
VA
Enumeration date
06/12/2018
Last updated
11/11/2025
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