Individual
MALLORY O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
9709 BUCHANAN LOOP, MANASSAS, VA 20110-7856
(571) 379-4246
Mailing address
11045 SAFFOLD WAY, RESTON, VA 20190-3808
(540) 935-7124
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024185189
VA
Other
Enumeration date
11/25/2022
Last updated
01/16/2025
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