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Individual

SUJARANI ANTOCHEN KOOLIPURACKAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGPCNP

Contact information

Practice address
1200 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4456
(540) 741-3900
Mailing address
1200 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4456
(540) 741-3900

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024181137
VA

Other

Enumeration date
04/25/2021
Last updated
04/25/2021
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