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Individual

ANGELA S GOODSON-ACEVEDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14121 PARKE LONG CT, CHANTILLY, VA 20151-1647
(571) 449-3585
Mailing address
14121 PARKE LONG CT, CHANTILLY, VA 20151-1647
(571) 449-3585

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015423
IL

Other

Enumeration date
12/04/2017
Last updated
05/08/2018
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