Individual
MKIYAH TELEZA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
1129 HEATHERSTONE DR, FREDERICKSBURG, VA 22407-4828
(540) 785-8500
(540) 785-5328
Mailing address
1129 HEATHERSTONE DR, FREDERICKSBURG, VA 22407-4828
(540) 785-8500
(540) 785-5328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024168968
VA
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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