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Individual

MRS. MARY KATHERINE ROGOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
5715 CENTRE SQUARE DRIVE, CENTREVILLE- CHANTILLY FAMILY PRACTICE, CENTREVILLE, VA 20120-1916
(703) 631-5151
(703) 631-9754
Mailing address
5715 CENTRE SQUARE DRIVE, CENTREVILLE- CHANTILLY FAMILY PRACTICE, CENTREVILLE, VA 20120-1916
(703) 631-5151
(703) 631-9754

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0017001073
VA
363LF0000X
Family Nurse Practitioner
0001093340
VA
363LF0000X
Family Nurse Practitioner
Primary
0024093340
VA

Other

Enumeration date
10/04/2006
Last updated
11/24/2009
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