Individual
MRS. ELIZABETH GWEN CHOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
224D CORNWALL ST NW, # 104, LEESBURG, VA 20176-2700
(703) 779-0699
(703) 779-7712
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024167904
VA
363LP0200X
Pediatric Nurse Practitioner
SP009249
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568677326
—
VA
Enumeration date
05/14/2007
Last updated
11/13/2012
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