Individual
REBECCA SUZANNE MARIE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-PC
Contact information
Practice address
3060 WILLIAMS DR STE 520, FAIRFAX, VA 22031-4648
(703) 289-1400
Mailing address
4401 4TH ST N APT 136, ARLINGTON, VA 22203-3027
(808) 343-2288
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024191102
VA
Other
Enumeration date
09/27/2024
Last updated
09/30/2024
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