Individual
MS. DOREEN FAYE GRZELAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
44035 RIVERSIDE PKWY STE 300, LEESBURG, VA 20176-8260
(703) 554-6800
(703) 724-7503
Mailing address
3040 WILLIAMS DR STE 100, FAIRFAX, VA 22031-4618
(571) 350-8400
(703) 940-8697
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024168894
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316241854
—
VA
01
—
489421ZAN3
MEDICARE PTAN
DC
01
—
VVY852A
MEDICARE PTAN
VA
Enumeration date
12/24/2010
Last updated
10/26/2022
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