Individual
DR. DEIRDRE MARY CAROLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, PH.D.
Contact information
Practice address
3300 GALLOWS RD, INOVA FAIRFAX HOSPITAL, FALLS CHURCH, VA 22042-3307
(703) 776-3789
Mailing address
914 WESTWOOD DR NE, VIENNA, VA 22180-3642
(703) 776-3789
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0001-066408
VA
363LG0600X
Gerontology Nurse Practitioner
001066408
VA
364SG0600X
Gerontology Clinical Nurse Specialist
15000207
VA
Other
Enumeration date
06/29/2007
Last updated
06/11/2012
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