Individual
LOVERLY GLAZE PELAYO-PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3289 WOODBURN RD STE 320, ANNANDALE, VA 22003-7354
(571) 308-1830
(571) 308-1843
Mailing address
3289 WOODBURN RD STE 320, ANNANDALE, VA 22003-7354
(571) 308-1830
(571) 308-1843
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0017145514
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017145514
NURSE PRACTITIONER LICENSE
VA
Enumeration date
12/17/2018
Last updated
09/10/2024
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