Individual
KATHLEEN ANN TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14701 LEE HWY STE 303, CENTREVILLE, VA 20121-2135
(703) 830-4388
Mailing address
14701 LEE HWY STE 303, CENTREVILLE, VA 20121-2135
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
0024177081
VA
Other
Enumeration date
09/07/2018
Last updated
12/18/2018
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