Individual
KAALYN ROSE ZIZUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
46175 WESTLAKE DRIVE, SUITE 120, POTOMAC FALLS, VA 20165-5873
(703) 444-0100
(703) 444-7600
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
363A00000X
Physician Assistant
Primary
0110004109
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205174331
—
VA
05
—
30015891910003
—
VA
Enumeration date
01/24/2013
Last updated
10/31/2023
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