Individual
NICOLE PATRICIA CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19500 SANDRIDGE WAY, SUITE 110, LEESBURG, VA 20176-6821
(703) 723-7337
(703) 723-6848
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101226970
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6706649
—
VA
Enumeration date
08/30/2005
Last updated
10/15/2010
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