Individual
KATRINA MCTIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9206 LEAMINGTON CT, FAIRFAX, VA 22031-3813
(703) 489-8628
Mailing address
9206 LEAMINGTON CT, FAIRFAX, VA 22031-3813
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1219618
NATIONAL CERTIFICATION VIA NCCPA
—
Enumeration date
06/26/2024
Last updated
06/26/2024
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