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Individual

MIRNESA TIKVINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, CRNP, FNP-BC

Contact information

Practice address
6355 WALKER LN STE 510, ALEXANDRIA, VA 22310-3251
(703) 924-3144
Mailing address
6355 WALKER LN STE 510, ALEXANDRIA, VA 22310-3251
(703) 924-3144

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001283889
VA
363L00000X
Nurse Practitioner
Primary
0024185531
VA
363LF0000X
Family Nurse Practitioner
0024185531
VA

Other

Enumeration date
10/17/2020
Last updated
05/06/2024
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