Individual
MINNA MANALO BACARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8081 INNOVATION PARK DR, FAIRFAX, VA 22031-4867
(571) 472-1600
(571) 472-1601
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
RN966963
DC
363L00000X
Nurse Practitioner
Primary
0024172064
VA
Other
Enumeration date
07/12/2005
Last updated
10/12/2022
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