Individual
NEELY RICHARDSON FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4400 UNIVERSITY DR BLDG 1, FAIRFAX, VA 22030-4444
(703) 993-2831
(703) 993-4365
Mailing address
4400 UNIVERSITY DR BLDG 1, FAIRFAX, VA 22030-4444
(703) 993-2831
(703) 993-4365
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
LG-0000992
DE
363LF0000X
Family Nurse Practitioner
Primary
0024185660
VA
363LF0000X
Family Nurse Practitioner
5007466
NC
Other
Enumeration date
02/10/2015
Last updated
02/26/2024
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