Individual
MISS LOREN ANNE RAY TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8280 WILLOW OAKS CORPORATE DR STE 100, FAIRFAX, VA 22031-4517
(703) 269-3270
(703) 269-3271
Mailing address
10527 REEDS LANDING CIR, BURKE, VA 22015-2513
(201) 232-5162
(703) 289-4612
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024170891
VA
363LA2200X
Adult Health Nurse Practitioner
0024170891
VA
363LA2200X
Adult Health Nurse Practitioner
26NJ00060800
NJ
Other
Enumeration date
10/21/2005
Last updated
04/03/2026
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