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Individual

MS. DEBRA JEAN MASSARO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
13199 CENTERPOINTE WAY, WOODBRIDGE, VA 22193-5284
(540) 449-6077
Mailing address
17200 RIFFLE FORD RD, GERMANTOWN, MD 20874-2915
(154) 044-9607

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024174335
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0024174335
VA
Enumeration date
01/17/2017
Last updated
07/17/2023
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