Individual
MARIE BERNADETTE GASTON DIEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
8505 ARLINGTON BLVD, SUITE 400, FAIRFAX, VA 22031
(571) 226-5600
(571) 423-5067
Mailing address
8505 ARLINGTON BLVD, SUITE 400, FAIRFAX, VA 22033
(571) 226-5600
(571) 423-5067
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0001135171
VA
Other
Enumeration date
07/15/2006
Last updated
12/19/2012
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