Individual
MISS ANNA LISA LICUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
110 IRVING ST., NW, WHC SURGICAL CRITICAL CARE SERVICE SUITE 4B-42, WASHINGTON, DC 20010-2975
(202) 877-7259
Mailing address
9004 TEDDY RAE CT, SPRINGFIELD, VA 22152-2644
(571) 594-3405
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP1003124
DC
Other
Enumeration date
02/05/2007
Last updated
08/09/2024
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