Individual
KATHERINE JANE MANZANARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 NORTH BEAUREGARD STREET, SUITE 250, ALEXANDRIA, VA 22311-5879
(703) 370-2400
(703) 370-7214
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003633
VA
363AS0400X
Surgical Physician Assistant
PA030510
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316040660
—
VA
05
—
30017449730003
—
VA
Enumeration date
09/05/2006
Last updated
01/31/2024
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