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Individual

MS. SHAUNA MARIE SEVERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
10777 MAIN ST, FAIRFAX, VA 22030-6903
(703) 246-9776
Mailing address
11409 GREEN MOOR LN, OAKTON, VA 22124-1240
(703) 860-8811

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
0001070406
VA

Other

Enumeration date
11/29/2006
Last updated
07/08/2007
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